Adapting the Preterm Birth Phenotyping Framework to a Low-Resource, Rural Setting and Applying It to Births from Migori County in Western Kenya

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dc.contributor.authorMiller, Lara
dc.contributor.authorSchmidt, Christina N.
dc.contributor.authorWanduru, Phillip
dc.contributor.authorWanyoro, Anthony
dc.contributor.authorSantos, Nicole
dc.contributor.authorButrick, Elizabeth
dc.contributor.authorLester, Felicia
dc.contributor.authorOtieno, Phelgona
dc.contributor.authorWalker, Dilys
dc.date.accessioned2023-11-07T09:16:57Z
dc.date.available2023-11-07T09:16:57Z
dc.date.issued2023
dc.descriptionArticleen_US
dc.description.abstractBackground Preterm birth is the leading cause of neonatal and under-fve mortality worldwide. It is a complex syndrome characterized by numerous etiologic pathways shaped by both maternal and fetal factors. To better understand preterm birth trends, the Global Alliance to Prevent Prematurity and Stillbirth published the preterm birth phenotyping framework in 2012 followed by an application of the model to a global dataset in 2015 by Barros, et al. Our objective was to adapt the preterm birth phenotyping framework to retrospective data from a low-resource, rural setting and then apply the adapted framework to a cohort of women from Migori, Kenya. Methods This was a single centre, observational, retrospective chart review of eligible births from November 2015 – March 2017 at Migori County Referral Hospital. Adaptations were made to accommodate limited diagnostic capabilities and data accuracy concerns. Prevalence of the phenotyping conditions were calculated as well as odds of adverse outcomes. Results Three hundred eighty-seven eligible births were included in our study. The largest phenotype group was none (no phenotype could be identifed; 41.1%), followed by extrauterine infection (25.1%), and antepartum stillbirth (16.7%). Extrauterine infections included HIV (75.3%), urinary tract infections (24.7%), malaria (4.1%), syphilis (3.1%), and general infection (3.1%). Severe maternal condition was ranked fourth (15.6%) and included anaemia (69.5%), chronic respiratory distress (22.0%), chronic hypertension prior to pregnancy (5.1%), diabetes (3.4%), epilepsy (3.4%), and sickle cell disease (1.7%). Fetal anaemia cases were the most likely to transfer to the newborn unit (OR 5.1, 95% CI 0.8, 30.9) and fetal anomaly cases were the most likely to result in a pre-discharge mortality (OR 3.9, 95% CI 0.8, 19.2). Conclusions Using routine data sources allowed for a retrospective analysis of an existing dataset, requiring less time and fewer resources than a prospective study and demonstrating a feasible approach to preterm phenotyping for use in low-resource settings to inform local prevention strategies.en_US
dc.identifier.citationMiller, L., Schmidt, C. N., Wanduru, P., Wanyoro, A., Santos, N., Butrick, E., ... & Walker, D. (2023). Adapting the preterm birth phenotyping framework to a low-resource, rural setting and applying it to births from Migori County in western Kenya. BMC Pregnancy and Childbirth, 23(1), 729.en_US
dc.identifier.urihttps://doi.org/10.1186/s12884-023-06012-7
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/27135
dc.language.isoenen_US
dc.publisherBMCen_US
dc.subjectPremature birthen_US
dc.subjectPhenotypeen_US
dc.subjectMaternal infectionen_US
dc.subjectPerinatal mortalityen_US
dc.titleAdapting the Preterm Birth Phenotyping Framework to a Low-Resource, Rural Setting and Applying It to Births from Migori County in Western Kenyaen_US
dc.typeArticleen_US
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