Factors associated with spontaneous abortion and to implement a home based post abortion care protocol from a prevention perspective in a rural part of Odisha, South-Eastern India: a hospital based cross-sectional study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20223487Keywords:
Spontaneous abortion, reproductive health, recurrent spontaneous miscarriage, primary health care, risk factors, contraceptivesAbstract
Background: Spontaneous abortion (SA) is one of the most common unfavourable reproductive outcomes among women around the world, making maternal health promotion a major challenge. The aim of the current study was to identify the potential predictors associated with SA and recognized the need for providing home-based post-abortion care counselling to lower post abortion complications.
Methods: A hospital-based cross-sectional study was conducted among the rural women ages of 18 and 45 years who had experienced at least one spontaneous miscarriage of less than 20 weeks of pregnancy. Participants were interviewed using a standardized questionnaire that included demographic, socioeconomic, and reproductive health information. Home based post abortion care protocol was introduced among the target populations for prevention of post abortion complications and maternal satisfaction was assessed after one week of implementation.
Results: Of the 485 patients screened for eligibility, 24.12% had a history of at least one SA. The multivariate analysis revealed that occurrence of SA in our study is significantly associated with gravidity, multiparity, previous pregnancy complications, with a history of unfavourable fetal outcome and maternal comorbidities. Home based post abortion care protocol resulted higher maternal satisfaction and lower post abortion infection rate.
Conclusions: The findings of our study reveals multiple modifiable factors may increase the risk of spontaneous abortion. One of the community participatory interventions in terms of providing home based post abortion care module resulted a significant impact on improving maternal satisfaction and lower post abortion infection rate among rural women.
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References
Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Best practice & research Clinical obstetrics & gynaecology 2000; 14(5):839-54.
Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. Bmj 2000;320(7251):1708-12.
Patki A, Chauhan N. An epidemiology study to determine the prevalence and risk factors associated with recurrent spontaneous miscarriage in India. The Journal of Obstetrics and Gynecology of India 2016;66(5):310-5.
Singh S, Shekhar C, Acharya R, Moore AM, Stillman M, Pradhan MR, Frost JJ, Sahoo H, Alagarajan M, Hussain R, Sundaram A. The incidence of abortion and unintended pregnancy in India, 2015. The Lancet Global Health 2018;6(1):e111-20.
Gao GP, Zhang RJ, Zhang XJ, Jia XM, Li XD, Li X, Wang CC, Tong F, Sun YH. Prevalence and associated factors of induced abortion among rural married women: A cross‐sectional survey in A nhui, C hina. Journal of Obstetrics and Gynaecology Research 2015;41(3):383-91.
Galamb Á, Pethő B, Fekete D, Petrányi G, Pajor A. Uterine anomalies in women with recurrent pregnancy loss. Orvosi hetilap 2015;156(27):1081-4.
Hu X, Miao M, Bai Y, Cheng N, Ren X. Reproductive factors and risk of spontaneous abortion in the jinchang cohort. International Journal of Environmental Research and Public Health 2018;15(11):2444.
Gerdts C, Vohra D, Ahern J. Measuring unsafe abortion-related mortality: a systematic review of the existing methods. PloS one 2013;8(1):e53346.
Sedgh G, Bearak J, Singh S, Bankole A, Popinchalk A, Ganatra B, Rossier C, Gerdts C, Tunçalp Ö, Johnson Jr BR, Johnston HB. Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends. The Lancet 2016;388(10041):258-67.
Sethi B. Annual health survey-Key highlights for Odisha. Government of Odisha. 2011.
Kochar PS, Dandona R, Kumar GA, Dandona L. Population-based estimates of still birth, induced abortion and miscarriage in the Indian state of Bihar. BMC pregnancy and childbirth 2014;14(1):1-9.
Ganatra B, Tuncalp O, Johnston HB, Johnson Jr BR, Gulmezoglu AM, Temmerman M. From concept to measurement: operationalizing WHO's definition of unsafe abortion. Bulletin of the World Health Organization 2014; 92:155-.
Yassin KM. Incidence and socioeconomic determinants of abortion in rural upper Egypt. Public Health 2000;114(4):269-72.
Phelan JC, Link BG. Controlling disease and creating disparities: a fundamental cause perspective. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 2005;60(Special_Issue_2):S27-33.
Dhaded SM, Somannavar MS, Jacob JP, McClure EM, Vernekar SS, Yogesh Kumar S, Kavi A, Ramadurg UY, Moore JL, Wallace DP, Derman RJ. Early pregnancy loss in Belagavi, Karnataka, India 2014–2017: a prospective population-based observational study in a low-resource setting. Reproductive Health 2018;15(1):15-22.
Santos AP, Coelho ED, Gusmão ME, Silva DO, Marques PF, Almeida MS. Factors associated with abortion in women of reproductive age. Revista Brasileira de Ginecologia e Obstetrícia 2016;38:273-9.
De Valk HW, van Nieuwaal NH, Visser GH. Pregnancy outcome in type 2 diabetes mellitus: a retrospective analysis from the Netherlands. The Review of Diabetic Studies 2006;3(3):134.
Clark K, Barton JR, Istwan N, Rhea D, Desch C, Sibai A, Sibai BM. PP179. The influence of prior abortion on rates of gestational hypertension/pre-eclampsia and spontaneous preterm delivery in nulliparous women. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health 2012;2(3):337.
Iravani AT, Saeedi MM, Pakravesh J, Hamidi S, Abbasi M. Thyroid autoimmunity and recurrent spontaneous abortion in Iran: a case-control study. Endocrine Practice 2008;14(4):458-64.
WHO H. Sexual health and its linkages to reproductive health: an operational approach. Geneva: WHO. 2017.
Pallikadavath S, Stones RW. Maternal and social factors associated with abortion in India: a population-based study. International Family Planning Perspectives 2006; 120-5.
Berer M. Making abortions safe: a matter of good public health policy and practice. Bulletin of the World Health Organization 2000; 78:580-92.
Maharana B. Correlates of Spontaneous and Induced Abortion in India: an investigation using a nationwide large scale survey data. International Institute for Population Sciences, Mumbai, India 2011.
Larsen EC, Christiansen OB, Kolte AM, Macklon N. New insights into mechanisms behind miscarriage. BMC medicine 2013;11(1):1-0.
Yogi A, KC P, Neupane S. Prevalence and factors associated with abortion and unsafe abortion in Nepal: a nationwide cross-sectional study. BMC pregnancy and childbirth 2018 ;18(1):1-0.
Hinkosa L, Tamene A, Gebeyehu N. Risk factors associated with hypertensive disorders in pregnancy in Nekemte referral hospital, from July 2015 to June 2017, Ethiopia: case-control study. BMC Pregnancy and Childbirth 2020;20(1):1-9.
Saleh HS, Mowafy HE, Hameid AA, Sherif HE, Mahfouz EM. Does uterine fibroid adversely affect obstetric outcome of pregnancy? BioMed research international 2018;2018.
Nigro G, Mazzocco M, Mattia E, Di Renzo GC, Carta G, Anceschi MM. Role of the infections in recurrent spontaneous abortion. The Journal of Maternal-Fetal & Neonatal Medicine 2011 ;24(8):983-9.
Gonçalves RO, Santos WV, Sarno M, Cerqueira BA, Gonçalves MS, Costa OL. Chromosomal abnormalities in couples with recurrent first trimester abortions. Revista Brasileira de Ginecologia e Obstetrícia 2014; 36:113-7.