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Weekly miscarriage rates in a community-based prospective cohort study in rural western Kenya.

Author Information (click to view)

Dellicour S, Aol G, Ouma P, Yan N, Bigogo G, Hamel MJ, Burton DC, Oneko M, Breiman RF, Slutsker L, Feikin D, Kariuki S, Odhiambo F, Calip G, Stergachis A, Laserson KF, Ter Kuile FO, Desai M,


Dellicour S, Aol G, Ouma P, Yan N, Bigogo G, Hamel MJ, Burton DC, Oneko M, Breiman RF, Slutsker L, Feikin D, Kariuki S, Odhiambo F, Calip G, Stergachis A, Laserson KF, Ter Kuile FO, Desai M, (click to view)

Dellicour S, Aol G, Ouma P, Yan N, Bigogo G, Hamel MJ, Burton DC, Oneko M, Breiman RF, Slutsker L, Feikin D, Kariuki S, Odhiambo F, Calip G, Stergachis A, Laserson KF, Ter Kuile FO, Desai M,

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BMJ open 2016 4 156(4) e011088 doi 10.1136/bmjopen-2016-011088

Abstract
OBJECTIVE
Information on adverse pregnancy outcomes is important to monitor the impact of public health interventions. Miscarriage is a challenging end point to ascertain and there is scarce information on its rate in low-income countries. The objective was to estimate the background rate and cumulative probability of miscarriage in rural western Kenya.

DESIGN
This was a population-based prospective cohort.

PARTICIPANTS AND SETTING
Women of childbearing age were followed prospectively to identify pregnancies and ascertain their outcomes in Siaya County, western Kenya. The cohort study was carried out in 33 adjacent villages under health and demographic surveillance.

OUTCOME MEASURE
Miscarriage.

RESULTS
Between 2011 and 2013, among 5536 women of childbearing age, 1453 pregnancies were detected and 1134 were included in the analysis. The cumulative probability was 18.9%. The weekly miscarriage rate declined steadily with increasing gestation until approximately 20 weeks. Known risk factors for miscarriage such as maternal age, gravidity, occupation, household wealth and HIV infection were confirmed.

CONCLUSIONS
This is the first report of weekly miscarriage rates in a rural African setting in the context of high HIV and malaria prevalence. Future studies should consider the involvement of community health workers to identify the pregnancy cohort of early gestation for better data on the actual number of pregnancies and the assessment of miscarriage.

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