Association Between Previous Abortion And The Subsequent Pregnancy Outcomes Among Women Who Delivered At The Regional Referral Hospitals In Dar Es Salaam.

Abstract

Background: Globally, women experience an estimated rate of 28 million spontaneous abortions and 2.6 million stillbirths. Abortion or spontaneous pregnancy loss before 28 completed weeks of gestation is estimated to affect 10–15% of pregnancies. In Tanzania, the rate of abortion was estimated to be around 15%. Both spontaneous abortion and induced abortion have been associated with adverse pregnancy outcomes in the subsequent pregnancy including; preterm birth, low birth weight and stillbirth. Aim: To determine the association between previous abortion and the subsequent pregnancy outcomes among women who delivered at the regional referral hospitals in Dar es Salaam. Methods: A retrospective cohort study was conducted at Mwananyamala, Temeke and Amana Regional Referral hospitals in Dar es salaam. A total of 400 post-delivery women with a prior history of abortion and 400 with a live birth in the first pregnancy were enrolled in the study. Data was obtained from the patients’ files in the post-natal ward, antenatal cards and from the patient using an interviewer structured questionnaire. The dependent variables were gestational age at delivery, birth weight and fetal status at birth. The independent variable was a history of abortion in the first pregnancy. Data analysis was entered into the Statistical Package for Social Scientists (SPSS) version 23 and analysis was done with chi-square test and logistic regression analysis. The P-value of <0.05 was considered significant. Results: Preterm delivery was more common among women with a previous history of abortion, 9.2% as compared to 5.2% in women who had a live birth in the previous pregnancy. Women with a history of abortion were found to have an increased risk of getting pre-term delivery compared with those with no history of abortion (RR= 1.04, 95% CI 1.00 – 1.07). In addition, a history of abortion was found to have no association with stillbirth or low birth weight. vi Conclusion: The previous history of abortion was associated with a risk of preterm delivery in the subsequent pregnancy. In addition, a history of abortion was found to have no association with stillbirth or low birth weight