Frequency, risk factors, and adverse feto-maternal outcomes of placenta Previa in Northern Tanzania

Elizabeth Eliet Senkoro, Amasha H. Mwanamsangu, Fransisca Seraphin Chuwa3, Sia Emmanuel Msuya, Oresta Peter Mnali, Benjamin G. Brown, Michael Johnson Mahande
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Background: Placenta previa is a potential risk factor for obstetric hemorrhage, which is a major cause of feto-maternal morbidity and mortality in developing countries. Little is known about PP and associated adverse outcomes in Tanzania. This study aimed to determine frequency, risk factors and adverse feto-maternal outcomes of placenta previa in Northern Tanzania.

Methodology: We conducted a retrospective cohort study using maternally-linked data from the Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. Adjusted odds ratios (ORs) with 95% confidence intervals for risk factors and adverse feto-maternal outcomes associated with placenta previa were estimated in multivariable logistic regression models.

Results: A total of 47,686 singleton deliveries were analyzed. The frequency of placenta previa was 0.6%. Notable risk factors included gynecological diseases [OR 2.44; 95% CI: 1.5-3.97], alcohol consumption during pregnancy [OR 1.61; 95% CI: 1.17-2.21], Malpresentation [OR 4.28; 95% CI: 2.28-8.10] and gravidity ≥5 [OR 4.85; 95% CI: 1.49-15.75]. Adverse maternal outcomes were Postportum haemorrhage [OR 17.6; 95% CI: 8.6-36.2], Antepartum haemorrhage [OR 9.21; 95% CI: 5.3-16.0], Caesarean delivery [OR 9.68; 95% CI: 6.66-14.1]. placentaprevia increased odds of fetal Malpresentation [OR 4.30; 95% CI: 2.27-8.13], and early neonatal death [OR 3.75; 95% CI: 1.15-12.3].

Conclusion: The prevalence of placenta previa was comparable to that found in past research. Multiple independent risk factors were identified. Placenta previa was found to have associations with several adverse fetomaternal outcomes. Early identification of women at risk of placenta previa may help clinicians prevent such complications.