RT Journal Article
SR Electronic
T1 Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e011088
DO 10.1136/bmjopen-2016-011088
VO 6
IS 4
A1 Stephanie Dellicour
A1 George Aol
A1 Peter Ouma
A1 Nicole Yan
A1 Godfrey Bigogo
A1 Mary J Hamel
A1 Deron C Burton
A1 Martina Oneko
A1 Robert F Breiman
A1 Laurence Slutsker
A1 Daniel Feikin
A1 Simon Kariuki
A1 Frank Odhiambo
A1 Gregory Calip
A1 Andreas Stergachis
A1 Kayla F Laserson
A1 Feiko O ter Kuile
A1 Meghna Desai
YR 2016
UL http://bmjopen.bmj.com/content/6/4/e011088.abstract
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.