By Gatonye Gathura
Enjoying a tipple while pregnant and a history of abortion are major causes of high rates of premature births in the country. A report published recently shows more than 20 per cent of deliveries at Kenyatta National Hospital (KNH) are preterm.
The authors say this is much higher than the national prevalence rate at 12.3 per cent as well as the continental levels of 11.9 per cent. “The high prevalence rate in this study could be due to the fact that KNH is the main national referral hospital where complicated cases are referred and admitted for specialized care,” says the study.
Study authors Okubatsion Tekeste Okube and Lillian Moraa Sambu of the Catholic University of Eastern Africa, Nairobi says these data shows preterm deliveries is a serious health problem in Kenya even at this age.
Children born before 37 weeks or 259 days, doctors explain are at high risk of short and long term health risks including poor development and even early death. In the study appearing in the Open Journal of Obstetrics and Gynecology, Okube and colleague had studied 183 women at the after delivery wards of KNH. “We did this study to determine the prevalence and factors associated with preterm birth at KNH,” says Okube in their study.
In the study approved by the hospital’s ethical review committee, the duo found 20.2 per cent of deliveries at the facility to have come before time. Alcohol consumption during pregnancy, history of abortion, older age, hypertension and urinary tract infections were some of the reasons the women had delivered before time.
Women who reported consuming alcohol while pregnant were almost three times likely to deliver before time. At the same time women with a history of abortion were eight times more likely to deliver before time compared to those who have never aborted.
The authors also explain that taking alcohol while pregnant can increase the risk of spontaneous abortion. “Alcohol consumption can increase the risk of spontaneous abortion by up to four fold especially in the first trimester,” says the study.
While data on the number of women who drink while nursing a pregnancy, was hard to come by the 2014 Demographic and Health Survey shows five per cent of women take alcohol at least once a month. It also shows that it can take up to five weeks before a pregnancy is recognised, during which time alcohol use may be high and lead to lifelong adverse consequences for the foetus.
While the current Constitution and the recently enacted Health Bill 2017 makes legal abortion easier in Kenya, the KNH study shows such a choice may have consequences in future child bearing. Of the study population, 14 mothers had a history of abortion. Out of these, six or about 43 per cent had premature births.
“Women with a history of abortion had a 3.5-fold increased chance of delivering a preterm baby compared to never aborted mothers,” says the study. Alcohol and abortion however are not the only factors responsible for preterm births with others being the age of the mother, hypertension and urinary tract infections.
The findings also send caution to women who deliberately or for other reasons delay having children. “Mothers in the age group of 31 years and above had significantly higher likelihoodof delivering a preterm baby compared to younger women.” In the older woman, the duo says the uterine environment become less favorablefor the growing fetus hence likely to be expelled before due date.
“Also the uterine muscles become weak to hold pregnancy to term.” The study also found being single or a student and failure to attend antenatal clinics all increased the risk of premature deliveries. Luckily the team says this high incidence of preterm babies can be lowered if not entirely avoided with highly targeted community health education.
