Association between Prenatal Care Utilization and Risk of Preterm Birth among Chinese Women

It is recognized that prenatal care plays an important role in reducing adverse birth. Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits. This study was to estimate the association between prenatal care utilization（PCU） and preterm birth（PTB）, and to investigate if medical conditions during pregnancy modified the association. This population-based case control study sampled women with PTB as cases; one control for each case was randomly selected from women with term births. The Electronic Perinatal Health Care Information System（EPHCIS） and a questionnaire were used for data collection. The PCU was measured by a renewed Prenatal Care Utilization（APNCU） index. Logistic regression models were used to estimate odds ratios（OR） and the 95% confidence interval（95% CI）. Totally, 2393 women with PTBs and 4263 women with term births were collected. In this study, 695（10.5%） women experienced inadequate prenatal care, and 5131（77.1%） received adequate plus prenatal care. Inadequate PCU was associated with PTB（adjusted OR： 1.41, 95% CI： 1.32–1.84）; the similar positive association was found between adequate plus PCU and PTB. Among women with medical conditions, these associations still existed; but among women without medical conditions, the association between inadequate PCU and PTB disappeared. Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB, but it does depend on whether the woman has a medical condition during pregnancy.

Outcome of Very Premature Newborns in a Referral Hospital in a Resource-Limited Setting

Background: In Cameroon, prematurity is considered among the first cause of neonatal mortality and the main cause of sequelae in children under 5 years old. Although some local teams have studied the causes of neonatal deaths, the survival of the very preterm babies in our context remains poorly known. Patients and Methods: We conducted a hospital-based cross-sectional study with both a retrospective and prospective data collection, covering a period of 5 years and 8 months, including 120 participants who presented with very preterm birth. Socio-demographic, anamnestic, and outcome features were studied. The assessment of the child’s psychomotor development was evaluated trough gross motor skills, fine motor skills, language and social contact. We calculated the development quotient (DQ) by dividing the developmental age (DA) by the actual age (RA) of the patient. Qualitative variables were expressed as numbers and percentages and quantitative variables as means ± standard deviations. Results: At the clinic, 23.8% of the children developed cerebral palsy, 3.1% had cerebral palsy with mental delay, and 6.6% had praxis disorders. Hearing impairment was observed in 6.3% of the survivors, visual impairment in 9%, and swallowing disorders in 7.6%. The mean developmental quotient was (89.98 ± 19.7) with a median of 93. A delay in developmental milestones was observed in 10.8%, speech disorder in 57%, severe malnutrition in 7.7%. The mortality rate was 48.5%. Conclusion: Very preterm birth is associated with a higher risk of neonatal death. Cognitive and motor disorders should not be underestimated. The harmonised management of very premature babies is highly recommended in our context for early diagnosis of sequelae.