Prevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022

Abstract Background Adverse birth outcomes (ABOs) cause significant infant morbidity and mortality in resource-limited settings. Many of the maternal risk factors associated with ABOs can be prevented. We present the prevalence, trends, and risk factors of selected ABOs from a hospital-based birth d...

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Main Authors: Ronald Kusolo, Daniel Mumpe-Mwanja, Robert Serunjogi, Augustina Delaney, Joyce Namale-Matovu, Kenneth Mwambi, Phoebe Monalisa Namukanja-Mayambala, Jennifer L. Williams, Cara T. Mai, Yan Ping Qi, Philippa Musoke
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07550-y
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author Ronald Kusolo
Daniel Mumpe-Mwanja
Robert Serunjogi
Augustina Delaney
Joyce Namale-Matovu
Kenneth Mwambi
Phoebe Monalisa Namukanja-Mayambala
Jennifer L. Williams
Cara T. Mai
Yan Ping Qi
Philippa Musoke
author_facet Ronald Kusolo
Daniel Mumpe-Mwanja
Robert Serunjogi
Augustina Delaney
Joyce Namale-Matovu
Kenneth Mwambi
Phoebe Monalisa Namukanja-Mayambala
Jennifer L. Williams
Cara T. Mai
Yan Ping Qi
Philippa Musoke
author_sort Ronald Kusolo
collection DOAJ
description Abstract Background Adverse birth outcomes (ABOs) cause significant infant morbidity and mortality in resource-limited settings. Many of the maternal risk factors associated with ABOs can be prevented. We present the prevalence, trends, and risk factors of selected ABOs from a hospital-based birth defects surveillance program in Kampala, Uganda. Methods We analyzed data for all mothers with singleton deliveries collected from four urban hospitals between 2015 and 2022. Prevalence of preterm birth [PTB], low birth weight [LBW], small for gestational age [SGA], and stillbirth [SB] and maternal HIV seroprevalence were calculated among 222,427 births. SB was defined as infant born without life ≥ 28 weeks of gestation, LBW as term live birth weighing < 2500 g and PTB as live birth born < 37 weeks of gestation. Time trends of ABOs by maternal HIV status and age were computed using quasi-Poisson regression model and presented graphically. Risk factor associations were estimated using robust Poisson models adjusting for infant sex, hospital of delivery, and birth year. Results Prevalence of PTB, LBW, SGA, and SB were 14.8%, 4.3%, 17.8%, and 3.1%, respectively. Maternal HIV seroprevalence was 7.7%. Compared to mothers aged 25–34 years, young adolescents 10–18 years was associated with PTB (adjusted risk ratio [aRR]: 1.44, 95% confidence interval (CI): 1.38–1.50); LBW (1.65,1.51–1.81); and SGA (1.18; 1.12–1.24). HIV seropositivity was associated with PTB (1.18; 1.14–1.22), LBW (1.54; 1.43–1.65), and SGA (1.28; 1.23–1.33). Compared to starting ANC in the first trimester, no antenatal care (ANC) was associated with PTB (2.44; 2.33–2.56), LBW (1.80; 1.55–2.09), SGA (1.37; 1.27–1.49), and SB (3.73; 3.32–4.15) and late attendance with LBW (1.09; 1.02–1.16), SGA (1.26; 1.22–1.30), and SB (1.09; 1.02–1.17). Our findings also indicate a rising trend in PTB among adolescent and young women aged 10–24 years, and a declining trend in LBW and SGA over time (ptrend < 0.05 for all). Conclusions Young maternal age, maternal HIV, and late or no ANC attendance were associated with ABO. Childbearing in the ages 25–34, preventing HIV in women, and supporting early and frequent ANC attendance are important in improving birth outcomes.
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spelling doaj-art-8c9f9341a0014b3c8cf9c255280c00972025-08-20T02:28:07ZengBMCBMC Pregnancy and Childbirth1471-23932025-04-0125111010.1186/s12884-025-07550-yPrevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022Ronald Kusolo0Daniel Mumpe-Mwanja1Robert Serunjogi2Augustina Delaney3Joyce Namale-Matovu4Kenneth Mwambi5Phoebe Monalisa Namukanja-Mayambala6Jennifer L. Williams7Cara T. Mai8Yan Ping Qi9Philippa Musoke10Makerere University– Johns Hopkins University Research CollaborationMakerere University– Johns Hopkins University Research CollaborationMakerere University– Johns Hopkins University Research CollaborationDivision of Global HIV and TB, U.S. Centers for Disease Control and Prevention (CDC)Makerere University– Johns Hopkins University Research CollaborationDivision of Global HIV and TB, U.S. Centers for Disease Control and Prevention (CDC)Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention (CDC)National Center on Birth Defects and Developmental Disabilities, CDCNational Center on Birth Defects and Developmental Disabilities, CDCNational Center on Birth Defects and Developmental Disabilities, CDCMakerere University– Johns Hopkins University Research CollaborationAbstract Background Adverse birth outcomes (ABOs) cause significant infant morbidity and mortality in resource-limited settings. Many of the maternal risk factors associated with ABOs can be prevented. We present the prevalence, trends, and risk factors of selected ABOs from a hospital-based birth defects surveillance program in Kampala, Uganda. Methods We analyzed data for all mothers with singleton deliveries collected from four urban hospitals between 2015 and 2022. Prevalence of preterm birth [PTB], low birth weight [LBW], small for gestational age [SGA], and stillbirth [SB] and maternal HIV seroprevalence were calculated among 222,427 births. SB was defined as infant born without life ≥ 28 weeks of gestation, LBW as term live birth weighing < 2500 g and PTB as live birth born < 37 weeks of gestation. Time trends of ABOs by maternal HIV status and age were computed using quasi-Poisson regression model and presented graphically. Risk factor associations were estimated using robust Poisson models adjusting for infant sex, hospital of delivery, and birth year. Results Prevalence of PTB, LBW, SGA, and SB were 14.8%, 4.3%, 17.8%, and 3.1%, respectively. Maternal HIV seroprevalence was 7.7%. Compared to mothers aged 25–34 years, young adolescents 10–18 years was associated with PTB (adjusted risk ratio [aRR]: 1.44, 95% confidence interval (CI): 1.38–1.50); LBW (1.65,1.51–1.81); and SGA (1.18; 1.12–1.24). HIV seropositivity was associated with PTB (1.18; 1.14–1.22), LBW (1.54; 1.43–1.65), and SGA (1.28; 1.23–1.33). Compared to starting ANC in the first trimester, no antenatal care (ANC) was associated with PTB (2.44; 2.33–2.56), LBW (1.80; 1.55–2.09), SGA (1.37; 1.27–1.49), and SB (3.73; 3.32–4.15) and late attendance with LBW (1.09; 1.02–1.16), SGA (1.26; 1.22–1.30), and SB (1.09; 1.02–1.17). Our findings also indicate a rising trend in PTB among adolescent and young women aged 10–24 years, and a declining trend in LBW and SGA over time (ptrend < 0.05 for all). Conclusions Young maternal age, maternal HIV, and late or no ANC attendance were associated with ABO. Childbearing in the ages 25–34, preventing HIV in women, and supporting early and frequent ANC attendance are important in improving birth outcomes.https://doi.org/10.1186/s12884-025-07550-yAdverse birth outcomesStillbirthPreterm birthLow birth weightSmall for gestational age
spellingShingle Ronald Kusolo
Daniel Mumpe-Mwanja
Robert Serunjogi
Augustina Delaney
Joyce Namale-Matovu
Kenneth Mwambi
Phoebe Monalisa Namukanja-Mayambala
Jennifer L. Williams
Cara T. Mai
Yan Ping Qi
Philippa Musoke
Prevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022
BMC Pregnancy and Childbirth
Adverse birth outcomes
Stillbirth
Preterm birth
Low birth weight
Small for gestational age
title Prevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022
title_full Prevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022
title_fullStr Prevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022
title_full_unstemmed Prevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022
title_short Prevalence, trends, and maternal risk factors of adverse birth outcomes from a hospital-based birth defects surveillance system in Kampala, Uganda, 2015–2022
title_sort prevalence trends and maternal risk factors of adverse birth outcomes from a hospital based birth defects surveillance system in kampala uganda 2015 2022
topic Adverse birth outcomes
Stillbirth
Preterm birth
Low birth weight
Small for gestational age
url https://doi.org/10.1186/s12884-025-07550-y
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