Population-Based Estimation of the Preterm Birth Rate in Lilongwe, Malawi: Making Every Birth Count

Kathleen M Antony; Peter N Kazembe; Ryan M Pace; Judy Levison; Henry Phiri; Grace Chiudzu; Ronald Alan Harris; Rose Chirwa; Mary Nyondo; Ellina Marko; Andrew Chigayo; Debora Nanthuru; Bertha Banda; Nicholas Twyman; Susan M Ramin; Susan P Raine; Michael A Belfort; Kjersti M Aagaard

doi:10.1055/s-0040-1708491

Population-Based Estimation of the Preterm Birth Rate in Lilongwe, Malawi: Making Every Birth Count

AJP Rep. 2020 Jan;10(1):e78-e86. doi: 10.1055/s-0040-1708491. Epub 2020 Mar 9.

Authors

Kathleen M Antony^{1

2

3}, Peter N Kazembe⁴, Ryan M Pace^{1

5}, Judy Levison¹, Henry Phiri⁶, Grace Chiudzu⁶, Ronald Alan Harris¹, Rose Chirwa⁴, Mary Nyondo⁴, Ellina Marko⁴, Andrew Chigayo⁴, Debora Nanthuru⁴, Bertha Banda⁴, Nicholas Twyman¹, Susan M Ramin^{1

2}, Susan P Raine¹, Michael A Belfort^{1

2}, Kjersti M Aagaard^{1

2}

Affiliations

¹ Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
² Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.
³ Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin.
⁴ Department of Pediatrics, Baylor College of Medicine Children's Clinical Center of Excellence, Kamuzu Central Hospital, Lilongwe, Malawi.
⁵ Department of Immunology, University of Idaho, Moscow, Idaho.
⁶ Department of Obstetrics and Gynecology, Kamuzu Central Hospital, Lilongwe, Malawi.

Abstract

Objective The objective of this study was to perform a population-based estimation of the preterm birth (PTB) rate in regions surrounding Lilongwe, Malawi. Study Design We partnered with obstetrician specialists, community health workers, local midwives, and clinicians in a 50 km region surrounding Lilongwe, Malawi, to perform a population-based estimation of the PTB rate during the study period from December 1, 2012 to May 19, 2015. Results Of the 14,792 births captured, 19.3% of births were preterm, including preterm early neonatal deaths. Additional PTB risk factors were similarly prevalent including domestic violence, HIV, malaria, anemia, and malnutrition. Conclusion When performing a population-based estimation of the rate of PTB, including women without antenatal care and women delivering at home, the 19.3% rate of PTB is among the highest recorded globally. This is accompanied by a high rate of risk factors and comorbid conditions.

Keywords: Malawi; global; global health; maternal health; preterm birth.

Grants and funding

Financial Support USAID/Bill & Melinda Gates Foundation Saving Lives at Birth Grand Challenges Grant: AID-OAA-G-11–00062 (K.M.A.); E.W. Al Thrasher Foundation (K.M.A.); and NIH K12 GM084897 (R.M.P.). E.W. Al Thrasher Foundation, Foundation for the National Institutes of Health, (award no.: K12 GM084897) USAID/Bill & Melinda Gates Foundation Saving Lives at Birth Grand Challenges Grant (grant no.: AID-OAA-G-11-00062).