The epidemiology of pregnancy outcomes in rural Burkina Faso

Jacqueline S. Bell, Moctar Ouedraogo, Rasmane Ganaba, Issiaka Sombie, Peter Byass, Rebecca F. Baggaley, Veronique Filippi, Ann E. Fitzmaurice, Wendy J. Graham

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objectives To describe levels and causes of pregnancy-related mortality and selected outcomes after pregnancy (OAP) in two districts of Burkina Faso.

Methods A household census was conducted in the two study districts, recording household deaths to women aged 12-49 years from 2001 to 2006. Questions on pregnancy outcomes in the last 5 years for resident women of reproductive age were included, and an additional method - direct sisterhood - was added in part of the area. Adult female deaths were followed-up with verbal autopsies (VA) with household members. A probabilistic model for interpreting VA data (InterVA-M) was used to determine distributions of probable causes of death. An OAP survey was conducted among all women with an experience of pregnancy during the prior 12 months. It aimed to document physical and psychological disabilities, economic and social consequences and discomfort that women may suffer as a result of a pregnancy.

Results The maternal mortality ratio (MMR) was 441 per 100 000 live births (95% CI: 397, 485), significantly higher in Diapaga [519 per 100 000 (95% CI: 454, 584)] than Ouargaye [353 per 100 000 (95% CI: 295, 411)]. MMRs were associated with wealth quintile, age and distance from a health facility. The causes of death showed higher than expected rates of sepsis (30%) and lower rates of haemorrhage (7%). A substantial proportion of all women had difficulty performing day-to-day tasks as a consequence of pregnancy. Women who had experienced stillbirths or Caesarean sections reported symptom-related indicators of poor physical health more frequently than women reporting uncomplicated deliveries, and were also more likely to be depressed.

Conclusions Expectations on the levels and causes of pregnancy-related mortality in Burkina Faso may need to be re-examined, and this could have programmatic implications; for example high levels of sepsis could prompt renewed efforts to reach women with skilled attendance at delivery and follow-up during the postpartum period. Further documentation of how complication-induced disabilities affect women and their families is needed. For mortality and morbidity outcomes, demonstrating variation between study districts is important to empower local decision makers with evidence of need at a subnational level.

Original languageEnglish
Pages (from-to)31-43
Number of pages13
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume13
Issue numberS1
Early online date10 Jun 2008
DOIs
Publication statusPublished - Jul 2008

Keywords

  • maternal mortality
  • maternal morbidity
  • pregnancy-related mortality
  • outcomes after pregnancy
  • causes of death
  • safe motherhood
  • Burkina Faso
  • Africa
  • health
  • death
  • depression
  • prevalence
  • morbidity
  • survival
  • distress

Cite this

Bell, J. S., Ouedraogo, M., Ganaba, R., Sombie, I., Byass, P., Baggaley, R. F., ... Graham, W. J. (2008). The epidemiology of pregnancy outcomes in rural Burkina Faso. American Journal of Tropical Medicine and Hygiene, 13(S1), 31-43. https://doi.org/10.1111/j.1365-3156.2008.02085.x

The epidemiology of pregnancy outcomes in rural Burkina Faso. / Bell, Jacqueline S.; Ouedraogo, Moctar; Ganaba, Rasmane; Sombie, Issiaka; Byass, Peter; Baggaley, Rebecca F.; Filippi, Veronique; Fitzmaurice, Ann E.; Graham, Wendy J.

In: American Journal of Tropical Medicine and Hygiene, Vol. 13, No. S1, 07.2008, p. 31-43.

Research output: Contribution to journalArticle

Bell, JS, Ouedraogo, M, Ganaba, R, Sombie, I, Byass, P, Baggaley, RF, Filippi, V, Fitzmaurice, AE & Graham, WJ 2008, 'The epidemiology of pregnancy outcomes in rural Burkina Faso', American Journal of Tropical Medicine and Hygiene, vol. 13, no. S1, pp. 31-43. https://doi.org/10.1111/j.1365-3156.2008.02085.x
Bell, Jacqueline S. ; Ouedraogo, Moctar ; Ganaba, Rasmane ; Sombie, Issiaka ; Byass, Peter ; Baggaley, Rebecca F. ; Filippi, Veronique ; Fitzmaurice, Ann E. ; Graham, Wendy J. / The epidemiology of pregnancy outcomes in rural Burkina Faso. In: American Journal of Tropical Medicine and Hygiene. 2008 ; Vol. 13, No. S1. pp. 31-43.
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title = "The epidemiology of pregnancy outcomes in rural Burkina Faso",
abstract = "Objectives To describe levels and causes of pregnancy-related mortality and selected outcomes after pregnancy (OAP) in two districts of Burkina Faso.Methods A household census was conducted in the two study districts, recording household deaths to women aged 12-49 years from 2001 to 2006. Questions on pregnancy outcomes in the last 5 years for resident women of reproductive age were included, and an additional method - direct sisterhood - was added in part of the area. Adult female deaths were followed-up with verbal autopsies (VA) with household members. A probabilistic model for interpreting VA data (InterVA-M) was used to determine distributions of probable causes of death. An OAP survey was conducted among all women with an experience of pregnancy during the prior 12 months. It aimed to document physical and psychological disabilities, economic and social consequences and discomfort that women may suffer as a result of a pregnancy.Results The maternal mortality ratio (MMR) was 441 per 100 000 live births (95{\%} CI: 397, 485), significantly higher in Diapaga [519 per 100 000 (95{\%} CI: 454, 584)] than Ouargaye [353 per 100 000 (95{\%} CI: 295, 411)]. MMRs were associated with wealth quintile, age and distance from a health facility. The causes of death showed higher than expected rates of sepsis (30{\%}) and lower rates of haemorrhage (7{\%}). A substantial proportion of all women had difficulty performing day-to-day tasks as a consequence of pregnancy. Women who had experienced stillbirths or Caesarean sections reported symptom-related indicators of poor physical health more frequently than women reporting uncomplicated deliveries, and were also more likely to be depressed.Conclusions Expectations on the levels and causes of pregnancy-related mortality in Burkina Faso may need to be re-examined, and this could have programmatic implications; for example high levels of sepsis could prompt renewed efforts to reach women with skilled attendance at delivery and follow-up during the postpartum period. Further documentation of how complication-induced disabilities affect women and their families is needed. For mortality and morbidity outcomes, demonstrating variation between study districts is important to empower local decision makers with evidence of need at a subnational level.",
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T1 - The epidemiology of pregnancy outcomes in rural Burkina Faso

AU - Bell, Jacqueline S.

AU - Ouedraogo, Moctar

AU - Ganaba, Rasmane

AU - Sombie, Issiaka

AU - Byass, Peter

AU - Baggaley, Rebecca F.

AU - Filippi, Veronique

AU - Fitzmaurice, Ann E.

AU - Graham, Wendy J.

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N2 - Objectives To describe levels and causes of pregnancy-related mortality and selected outcomes after pregnancy (OAP) in two districts of Burkina Faso.Methods A household census was conducted in the two study districts, recording household deaths to women aged 12-49 years from 2001 to 2006. Questions on pregnancy outcomes in the last 5 years for resident women of reproductive age were included, and an additional method - direct sisterhood - was added in part of the area. Adult female deaths were followed-up with verbal autopsies (VA) with household members. A probabilistic model for interpreting VA data (InterVA-M) was used to determine distributions of probable causes of death. An OAP survey was conducted among all women with an experience of pregnancy during the prior 12 months. It aimed to document physical and psychological disabilities, economic and social consequences and discomfort that women may suffer as a result of a pregnancy.Results The maternal mortality ratio (MMR) was 441 per 100 000 live births (95% CI: 397, 485), significantly higher in Diapaga [519 per 100 000 (95% CI: 454, 584)] than Ouargaye [353 per 100 000 (95% CI: 295, 411)]. MMRs were associated with wealth quintile, age and distance from a health facility. The causes of death showed higher than expected rates of sepsis (30%) and lower rates of haemorrhage (7%). A substantial proportion of all women had difficulty performing day-to-day tasks as a consequence of pregnancy. Women who had experienced stillbirths or Caesarean sections reported symptom-related indicators of poor physical health more frequently than women reporting uncomplicated deliveries, and were also more likely to be depressed.Conclusions Expectations on the levels and causes of pregnancy-related mortality in Burkina Faso may need to be re-examined, and this could have programmatic implications; for example high levels of sepsis could prompt renewed efforts to reach women with skilled attendance at delivery and follow-up during the postpartum period. Further documentation of how complication-induced disabilities affect women and their families is needed. For mortality and morbidity outcomes, demonstrating variation between study districts is important to empower local decision makers with evidence of need at a subnational level.

AB - Objectives To describe levels and causes of pregnancy-related mortality and selected outcomes after pregnancy (OAP) in two districts of Burkina Faso.Methods A household census was conducted in the two study districts, recording household deaths to women aged 12-49 years from 2001 to 2006. Questions on pregnancy outcomes in the last 5 years for resident women of reproductive age were included, and an additional method - direct sisterhood - was added in part of the area. Adult female deaths were followed-up with verbal autopsies (VA) with household members. A probabilistic model for interpreting VA data (InterVA-M) was used to determine distributions of probable causes of death. An OAP survey was conducted among all women with an experience of pregnancy during the prior 12 months. It aimed to document physical and psychological disabilities, economic and social consequences and discomfort that women may suffer as a result of a pregnancy.Results The maternal mortality ratio (MMR) was 441 per 100 000 live births (95% CI: 397, 485), significantly higher in Diapaga [519 per 100 000 (95% CI: 454, 584)] than Ouargaye [353 per 100 000 (95% CI: 295, 411)]. MMRs were associated with wealth quintile, age and distance from a health facility. The causes of death showed higher than expected rates of sepsis (30%) and lower rates of haemorrhage (7%). A substantial proportion of all women had difficulty performing day-to-day tasks as a consequence of pregnancy. Women who had experienced stillbirths or Caesarean sections reported symptom-related indicators of poor physical health more frequently than women reporting uncomplicated deliveries, and were also more likely to be depressed.Conclusions Expectations on the levels and causes of pregnancy-related mortality in Burkina Faso may need to be re-examined, and this could have programmatic implications; for example high levels of sepsis could prompt renewed efforts to reach women with skilled attendance at delivery and follow-up during the postpartum period. Further documentation of how complication-induced disabilities affect women and their families is needed. For mortality and morbidity outcomes, demonstrating variation between study districts is important to empower local decision makers with evidence of need at a subnational level.

KW - maternal mortality

KW - maternal morbidity

KW - pregnancy-related mortality

KW - outcomes after pregnancy

KW - causes of death

KW - safe motherhood

KW - Burkina Faso

KW - Africa

KW - health

KW - death

KW - depression

KW - prevalence

KW - morbidity

KW - survival

KW - distress

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DO - 10.1111/j.1365-3156.2008.02085.x

M3 - Article

VL - 13

SP - 31

EP - 43

JO - American Journal of Tropical Medicine and Hygiene

JF - American Journal of Tropical Medicine and Hygiene

SN - 0002-9637

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ER -