Prevalence of spontaneous abortion and associated factors among healthcare workers at Muhimbili national hospital in Dar es salaam, Tanzania

Abstract

ABSTRACT Background: Healthcare profession is one of the largest and significant labour-forces in the world, with more than 75% of female of child bearing age. Healthcare professionals handling potentially harmful chemicals may be more vulnerable to unfavorable health consequences including reproductive health issues such as spontaneous abortion. Spontaneous abortion can be caused by multiple factors which include genetic and non-genetic, the major genetic cause is chromosomal defects while non-genetic may include environmental and occupational factors however, other cases have unknown causes. Occupational health issues in healthcare landscape are notably under prioritized concern in Tanzania. Objective: To determine the prevalence of spontaneous abortion and associated factors among healthcare workers at Muhimbili National Hospital in Dar es Salaam, Tanzania Materials and Methods: A cross-sectional study involving 390 female workers was conducted at Muhimbili National Hospital. Self-administered questionnaires were used to collect information. Data management and analyses utilized STATA version 17. Data were coded for clear variable identification. Double data entry was performed to ensure data accuracy. Missing values and inconsistencies were identified and addressed to maintain data quality. Descriptive statistics summarized data. Means and medians for continuous variables and frequencies for categorical variables were computed. The prevalence of spontaneous abortion was derived from the number of reported cases divided by the total number of participants. Chi-square and Fisher's tests were run to assess the relationships between age, previous abortion, passive smoking, alcohol consumption, income, education level, gravidity, birth interval, previous pregnancy complication, maternal comorbidities and spontaneous abortion. Ergonomic factors, exposure to chemicals, violence and stress were also evaluated by using similar statistical tests. Modified Poisson regression analysis determined the independent effects of these variables adjusting for age, passive smoking, alcohol consumption and comorbidities to accurately estimate the relationships between the variables and spontaneous abortion, with significance established at a p-value below 0.05. Results: The results from this study reveal that among the 390 healthcare workers at Muhimbili National Hospital, 52 workers (13.33%) experienced spontaneous abortion. There is positive association between comorbidities and spontaneous abortion with PR of 1.95 (95% CI: 1.14-3.33), years of experience and spontaneous abortion with PR of 1.86 (95% CI: 1.12-3.07), gravidity and spontaneous abortion with PR of 4.06 (95% CI: 2.47-6.70) for those having 4-5 pregnancies compared to those with 1-3 also, there is positive association between access to personal protective equipment (PPE) and spontaneous abortion with PR of 1.86 (95% CI: 1.05-3.20).There is negative association between parity and spontaneous abortion with PR of 0.28 (95% CI: 0.13-0.59) for participants having 1-5 children compared to those with no children. Conclusion and Recommendation: The study revealed a 13.33% prevalence of spontaneous abortion among healthcare workers at Muhimbili National Hospital in Dar es Salaam. Key predictors of spontaneous abortion were comorbidities, years of work experience, gravidity, parity and access to PPE. To address these factors hospital administrators are advised to conduct comprehensive health screening and regular check-ups for healthcare workers, develop education programs to raise awareness about identified risk factors, modify workplace policies to accommodate specific needs of pregnant healthcare workers and researchers should conduct further research to explore the underlying causes of unexpected association between PPE and spontaneous abortion.