Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis

Abstract Background Although the use of prenatal ultrasound services has increased in low- income and lower middle-income countries, there has not been a concurrent improvement in perinatal mortality. It remains unknown whether individual ultrasound findings in this setting are associated with neona...

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Autores principales:	Delia Horn, Erika Edwards, Renny Ssembatya, Kristen DeStigter, Anne Dougherty, Danielle Ehret
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Ultrasound Neonatal Perinatal Mortality LMIC LIC Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/995d9822e83b4a5092039bf617e7f1b6
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spelling	oai:doaj.org-article:995d9822e83b4a5092039bf617e7f1b62021-11-14T12:32:40ZAssociation between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis10.1186/s12884-021-04204-71471-2393https://doaj.org/article/995d9822e83b4a5092039bf617e7f1b62021-11-01T00:00:00Zhttps://doi.org/10.1186/s12884-021-04204-7https://doaj.org/toc/1471-2393Abstract Background Although the use of prenatal ultrasound services has increased in low- income and lower middle-income countries, there has not been a concurrent improvement in perinatal mortality. It remains unknown whether individual ultrasound findings in this setting are associated with neonatal death or the need for resuscitation at delivery. If associations are identified by ultrasound, they could be used to inform the birth attendant and counsel the family regarding risk, potentially altering delivery preparedness in order to reduce neonatal mortality. Methods This was a secondary analysis of data collected from a prospective cohort. Data was gathered at Nawanyago Health Centre III in Kamuli District, Uganda. Participants included pregnant women who received second and third trimester prenatal ultrasound scans and delivered at that center between July 2010 and August 2018. All ultrasounds were performed at Nawanyago and deliveries were attended solely by midwives or nurses. Predictor variables included the following ultrasound findings: fetal number, fetal presentation, and amniotic fluid volume. The primary outcome was bag-mask ventilation (BMV) of the neonate at delivery. The secondary outcome was stillbirth or neonatal death in the delivery room. Results Primary outcome data was available for 1105 infants and secondary outcome data was available for 1098 infants. A total of 33 infants received BMV at delivery. The odds of receiving BMV at delivery was significantly increased if amniotic fluid volume was abnormal (OR 4.2, CI 1.2-14.9) and there were increased odds for multiple gestation (OR 1.9, CI 0.7-5.4) and for non-vertex fetal presentation (OR 1.4, CI 0.6-3.2) that were not statistically significant. Stillbirth or neonatal death in the delivery room was diagnosed for 20 infants. Multiple gestation (OR 4.7, CI 1.6-14.2) and abnormal amniotic fluid volume (OR 4.8, CI 1.0-22.1) increased the odds of stillbirth or neonatal death in the delivery room, though only multiple gestation was statistically significant. Conclusion Common findings that are easily identifiable on ultrasound in low- and lower middle-income countries are associated with adverse perinatal outcomes. Education could lead to improved delivery preparedness, with the potential to reduce perinatal mortality. This was a preliminary study; larger prospective studies are needed to confirm these findings.Delia HornErika EdwardsRenny SsembatyaKristen DeStigterAnne DoughertyDanielle EhretBMCarticleUltrasoundNeonatalPerinatalMortalityLMICLICGynecology and obstetricsRG1-991ENBMC Pregnancy and Childbirth, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ultrasound Neonatal Perinatal Mortality LMIC LIC Gynecology and obstetrics RG1-991
spellingShingle	Ultrasound Neonatal Perinatal Mortality LMIC LIC Gynecology and obstetrics RG1-991 Delia Horn Erika Edwards Renny Ssembatya Kristen DeStigter Anne Dougherty Danielle Ehret Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis
description	Abstract Background Although the use of prenatal ultrasound services has increased in low- income and lower middle-income countries, there has not been a concurrent improvement in perinatal mortality. It remains unknown whether individual ultrasound findings in this setting are associated with neonatal death or the need for resuscitation at delivery. If associations are identified by ultrasound, they could be used to inform the birth attendant and counsel the family regarding risk, potentially altering delivery preparedness in order to reduce neonatal mortality. Methods This was a secondary analysis of data collected from a prospective cohort. Data was gathered at Nawanyago Health Centre III in Kamuli District, Uganda. Participants included pregnant women who received second and third trimester prenatal ultrasound scans and delivered at that center between July 2010 and August 2018. All ultrasounds were performed at Nawanyago and deliveries were attended solely by midwives or nurses. Predictor variables included the following ultrasound findings: fetal number, fetal presentation, and amniotic fluid volume. The primary outcome was bag-mask ventilation (BMV) of the neonate at delivery. The secondary outcome was stillbirth or neonatal death in the delivery room. Results Primary outcome data was available for 1105 infants and secondary outcome data was available for 1098 infants. A total of 33 infants received BMV at delivery. The odds of receiving BMV at delivery was significantly increased if amniotic fluid volume was abnormal (OR 4.2, CI 1.2-14.9) and there were increased odds for multiple gestation (OR 1.9, CI 0.7-5.4) and for non-vertex fetal presentation (OR 1.4, CI 0.6-3.2) that were not statistically significant. Stillbirth or neonatal death in the delivery room was diagnosed for 20 infants. Multiple gestation (OR 4.7, CI 1.6-14.2) and abnormal amniotic fluid volume (OR 4.8, CI 1.0-22.1) increased the odds of stillbirth or neonatal death in the delivery room, though only multiple gestation was statistically significant. Conclusion Common findings that are easily identifiable on ultrasound in low- and lower middle-income countries are associated with adverse perinatal outcomes. Education could lead to improved delivery preparedness, with the potential to reduce perinatal mortality. This was a preliminary study; larger prospective studies are needed to confirm these findings.
format	article
author	Delia Horn Erika Edwards Renny Ssembatya Kristen DeStigter Anne Dougherty Danielle Ehret
author_facet	Delia Horn Erika Edwards Renny Ssembatya Kristen DeStigter Anne Dougherty Danielle Ehret
author_sort	Delia Horn
title	Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis
title_short	Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis
title_full	Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis
title_fullStr	Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis
title_full_unstemmed	Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis
title_sort	association between antenatal ultrasound findings and neonatal outcomes in rural uganda: a secondary analysis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/995d9822e83b4a5092039bf617e7f1b6
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Association between antenatal ultrasound findings and neonatal outcomes in rural Uganda: a secondary analysis

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