Prevalence of adverse neonatal outcome and association with HIV infection among postnatal women in Mtwara regional hospital, Tanzania.

Abstract

Background It is estimated that a global average of NMR is 30 neonatal deaths per 1000 live births. In 1995, 20.5million LBW were born and 16% of all new born in developing countries had LBW. Tanzania’s NMR is 32 deaths per 1000 deliveries. Preterm deliveries and LBW rate is 27% and 13% respectively. In Tanzania the prevalence of HIV/AIDS among pregnant women varies from 4-32%.

General objective: The objective of this study was to establish the prevalence of adverse neonatal outcomes and their association with HIV infection among postnatal women in Mtwara Regional Hospital

Methods: A cross sectional study was conducted between February and March 200 in Mtwara Reginal hospital (South east of Tanzania mainland). A total of 480 health postnatal women were selected by consecutive sampling. Data was collected from the participants using semi-structured questionnaire. EPI-DATA and SPSS computer packages were used for analysis of the data. Estimation of risk was done by computing Odd’s Ratio. Confounding and interaction between independent variables and the main independent variable (HIV) were assessed using logistic regression

Results: The overall prevalence of adverse neonatal outcome (neonatal death, low birth weight and preterm delivery) was (28%, n=132), 95% CI= 24.0-32.0). In this study it also was found postnatal women with HIV infection had about (OR=3.6, CI 2.2-5.7) more than four times risk of getting adverse neonatal outcome than among postnatal women of no HIV infection. Other predictors which independently associated with adverse neonatal outcome were History of adverse neonatal outcome in prior pregnancy (OR=2.64, CI 1.6-4.8), history of other diseases during pregnancy e.g. malaria (OR=2.64 CI, 1.5-4.4) and residence in rural area (OR=1.75, 1.05- 2.9). Some independent variables confounded the main predictor HIV infection, these were drinking alcohol (OR=1.69, CI 1.01-2.9), non education (OR=4.68, CI 1.2-17.9) and high blood pressure (OR=2.29, CI 0.7-5.9).

Conclusions: This study has found postnatal women in Mtwara regional hospital are at high risk of getting newborns with adverse outcome. Three in every ten postnatal women have a risk of getting a newborn with at least one adverse outcome in a year. Postnatal women of Mtwara Regional Hospital with HIV infection are at about four times more risk of getting newborn with adverse outcome as compared to non infected ones.