PT  - JOURNAL ARTICLE
AU  - Stephanie Dellicour
AU  - George Aol
AU  - Peter Ouma
AU  - Nicole Yan
AU  - Godfrey Bigogo
AU  - Mary J Hamel
AU  - Deron C Burton
AU  - Martina Oneko
AU  - Robert F Breiman
AU  - Laurence Slutsker
AU  - Daniel Feikin
AU  - Simon Kariuki
AU  - Frank Odhiambo
AU  - Gregory Calip
AU  - Andreas Stergachis
AU  - Kayla F Laserson
AU  - Feiko O ter Kuile
AU  - Meghna Desai
TI  - Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya
AID  - 10.1136/bmjopen-2016-011088
DP  - 2016 Apr 01
TA  - BMJ Open
PG  - e011088
VI  - 6
IP  - 4
4099  - http://bmjopen.bmj.com/content/6/4/e011088.short
4100  - http://bmjopen.bmj.com/content/6/4/e011088.full
SO  - BMJ Open2016 Apr 01; 6
AB  - Objective Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya.Design This was a population-based prospective cohort.Participants and setting Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance.Outcome measure Miscarriage.Results Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed.Conclusions This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage.