Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2009

Open Access 01-12-2009 | Research article

Impact of change in maternal age composition on the incidence of Caesarean section and low birth weight: analysis of delivery records at a tertiary hospital in Tanzania, 1999–2005

Authors: Projestine S Muganyizi, Hussein L Kidanto

Published in: BMC Pregnancy and Childbirth | Issue 1/2009

Login to get access

Abstract

Background

Previous studies on change in maternal age composition in Tanzania do not indicate its impact on adverse pregnancy outcomes. We sought to establish temporal changes in maternal age composition and their impact on annual Caesarean section (CS) and low birth weight deliveries (LBWT) at Muhimbili National Hospital in Tanzania.

Methods

We conducted data analysis of 91,699 singleton deliveries that took place in the hospital between 1999 and 2005. The data were extracted from the obstetric data base. Annual proportions of individual age groups were calculated and their trends over the years studied. Multiple logistic analyses were conducted to ascertain trends in the risks of CS and LBWT. The impact of age composition changes on CS and LBWT was estimated by calculating annual numbers of these outcomes with and without the major changes in age composition, all others remaining equal. In all statistics, a p value < 0.05 was considered significant.

Results

The proportion of teenage mothers (12–19 years) progressively decreased over time while that of 30–34 years age group increased. From 1999, the risk of Caesarean delivery increased steadily to a maximum in 2005 [adjusted OR = 1.7; 95%CI (1.6–1.8)] whereas that of LBWT declined to a minimum in 2005 (adjusted OR = 0.76; 95% CI (0.71–0.82). The current major changes in age trend were responsible for shifts in the number of CS of up to206 cases per year. Likewise, the shift in LBWT was up to 158 cases per year, but the 30–34 years age group had no impact on this.

Conclusion

The population of mothers giving birth at MNH is progressively becoming older with substantial impact on the incidence of CS and LBWT. Further research is needed to estimate the health cost implications of this change.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hokama T, Binns C: Trends in the prevalence of low birth weight in Okinawa, Japan: a public health perspective. Acta Paediatr. 2009, 98 (2): 242-6. 10.1111/j.1651-2227.2008.01017.x.CrossRefPubMed Hokama T, Binns C: Trends in the prevalence of low birth weight in Okinawa, Japan: a public health perspective. Acta Paediatr. 2009, 98 (2): 242-6. 10.1111/j.1651-2227.2008.01017.x.CrossRefPubMed
2.
go back to reference Anachebe NF, Sutton MY: Racial disparities in reproductive health outcomes. Am J Obstet Gynecol. 2003, 188 (4): S37-42. 10.1067/mob.2003.245.CrossRefPubMed Anachebe NF, Sutton MY: Racial disparities in reproductive health outcomes. Am J Obstet Gynecol. 2003, 188 (4): S37-42. 10.1067/mob.2003.245.CrossRefPubMed
3.
go back to reference Planned Parenthood Federation of America Inc: Pregnancy and childbearing among US teens. 1993, New York: Planned Parenthood Federation of America Inc Planned Parenthood Federation of America Inc: Pregnancy and childbearing among US teens. 1993, New York: Planned Parenthood Federation of America Inc
5.
go back to reference Glinianaia SV, Rankin J, Pless-Mulloli , Pearce M, Charlton M, Parker L: Temporal changes in key maternal and fetal factors affecting birth outcomes: A 32-year population based study in an industrial city. BMC Pregnancy and Childbirth. 2008, 8: 39-10.1186/1471-2393-8-39. Accessed 16/7/2009CrossRefPubMedPubMedCentral Glinianaia SV, Rankin J, Pless-Mulloli , Pearce M, Charlton M, Parker L: Temporal changes in key maternal and fetal factors affecting birth outcomes: A 32-year population based study in an industrial city. BMC Pregnancy and Childbirth. 2008, 8: 39-10.1186/1471-2393-8-39. Accessed 16/7/2009CrossRefPubMedPubMedCentral
6.
go back to reference Gupta N, Mahy M: Sexual initiation among adolescent girls and boys: trends and differentials in sub-Saharan Africa. Arch Sex Behav. 2003, 32 (1): 41-53. 10.1023/A:1021841312539.CrossRefPubMed Gupta N, Mahy M: Sexual initiation among adolescent girls and boys: trends and differentials in sub-Saharan Africa. Arch Sex Behav. 2003, 32 (1): 41-53. 10.1023/A:1021841312539.CrossRefPubMed
7.
go back to reference Luke B, Brown MB: Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Hum Reprod. 2007, 22 (5): 1264-1272. 10.1093/humrep/del522.CrossRefPubMed Luke B, Brown MB: Elevated risks of pregnancy complications and adverse outcomes with increasing maternal age. Hum Reprod. 2007, 22 (5): 1264-1272. 10.1093/humrep/del522.CrossRefPubMed
8.
go back to reference Joseph KS, Allen AC, Dodds L, Turner LA, Scott H, Liston R: The perinatal effects of delayed childbearing. Obstet Gynecol. 2005, 105 (6): 1410-1418.CrossRefPubMed Joseph KS, Allen AC, Dodds L, Turner LA, Scott H, Liston R: The perinatal effects of delayed childbearing. Obstet Gynecol. 2005, 105 (6): 1410-1418.CrossRefPubMed
9.
go back to reference Schempf AH, Branum AM, Lukacs SL, Schoendorf KC: Maternal age and parityassociated risks of preterm birth: differences by race/ethnicity. Paediatr Perinat Epidemiol. 2007, 21 (1): 34-43. 10.1111/j.1365-3016.2007.00785.x.CrossRefPubMed Schempf AH, Branum AM, Lukacs SL, Schoendorf KC: Maternal age and parityassociated risks of preterm birth: differences by race/ethnicity. Paediatr Perinat Epidemiol. 2007, 21 (1): 34-43. 10.1111/j.1365-3016.2007.00785.x.CrossRefPubMed
10.
go back to reference Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M: Maternal age and foetal loss: population based register linkage study. BMJ. 2000, 320 (7251): 1708-1712. 10.1136/bmj.320.7251.1708.CrossRefPubMed Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M: Maternal age and foetal loss: population based register linkage study. BMJ. 2000, 320 (7251): 1708-1712. 10.1136/bmj.320.7251.1708.CrossRefPubMed
11.
go back to reference O'Leary CM, Bower C, Knuiman M, Stanley FJ: Changing risks of stillbirth and neonatal mortality associated with maternal age in Western Australia 1984–2003. Paediatr Perinat Epidemiol. 2007, 21 (6): 541-549. 10.1111/j.1365-3016.2007.00849.x.CrossRefPubMed O'Leary CM, Bower C, Knuiman M, Stanley FJ: Changing risks of stillbirth and neonatal mortality associated with maternal age in Western Australia 1984–2003. Paediatr Perinat Epidemiol. 2007, 21 (6): 541-549. 10.1111/j.1365-3016.2007.00849.x.CrossRefPubMed
12.
go back to reference Glinianaia SV, Rankin J, Bell R, Pearce MS, Parker L: Temporal changes in the distribution of population risk factors attenuate the reduction in perinatal mortality. J Clin Epidemiol. 2005, 58 (12): 1299-1307. 10.1016/j.jclinepi.2005.03.015.CrossRefPubMed Glinianaia SV, Rankin J, Bell R, Pearce MS, Parker L: Temporal changes in the distribution of population risk factors attenuate the reduction in perinatal mortality. J Clin Epidemiol. 2005, 58 (12): 1299-1307. 10.1016/j.jclinepi.2005.03.015.CrossRefPubMed
13.
go back to reference Forssas E, Gissler M, Sihvonen M, Hemminki E: Maternal predictors of perinatal mortality: the role of birthweight. Int J Epidemiol. 1999, 28 (3): 475-478. 10.1093/ije/28.3.475.CrossRefPubMed Forssas E, Gissler M, Sihvonen M, Hemminki E: Maternal predictors of perinatal mortality: the role of birthweight. Int J Epidemiol. 1999, 28 (3): 475-478. 10.1093/ije/28.3.475.CrossRefPubMed
14.
go back to reference Cooper LG, Leland NL, Alexander G: Effect of maternal age on birth outcomes among young adolescents. Soc Biol. 1995, 42 (1–2): 22-35.PubMed Cooper LG, Leland NL, Alexander G: Effect of maternal age on birth outcomes among young adolescents. Soc Biol. 1995, 42 (1–2): 22-35.PubMed
15.
go back to reference Muganyizi PS, Kidanto HL, Kazaura MR, Massawe SN: Caesarean section: Trend and associated factors in Tanzania. AJM. 2008, 2 (2): 65-68. Muganyizi PS, Kidanto HL, Kazaura MR, Massawe SN: Caesarean section: Trend and associated factors in Tanzania. AJM. 2008, 2 (2): 65-68.
16.
go back to reference Easterlin RA: "Modernization and Fertility: A Critical Essay.". Determinants of Fertility in Developing Countries. Edited by: Bulatao RA, Lee RD. 1983, New York: Academic Press, II: 562-586. Easterlin RA: "Modernization and Fertility: A Critical Essay.". Determinants of Fertility in Developing Countries. Edited by: Bulatao RA, Lee RD. 1983, New York: Academic Press, II: 562-586.
17.
go back to reference National Bureau of Statistics (NBS) and ORC Macro: Tanzania Demographic and health Survey 2004–05. 2005, Dar es salaam, Tanzania: National Bureau of Statistics and ORC Macro National Bureau of Statistics (NBS) and ORC Macro: Tanzania Demographic and health Survey 2004–05. 2005, Dar es salaam, Tanzania: National Bureau of Statistics and ORC Macro
18.
go back to reference World Health Organization (WHO): Unsafe abortion. Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000. 2004, Geneva, World Health Organization, Fourth World Health Organization (WHO): Unsafe abortion. Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2000. 2004, Geneva, World Health Organization, Fourth
19.
go back to reference Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M: Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol. 2007, 36 (2): 368-73. 10.1093/ije/dyl284.CrossRefPubMed Chen XK, Wen SW, Fleming N, Demissie K, Rhoads GG, Walker M: Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol. 2007, 36 (2): 368-73. 10.1093/ije/dyl284.CrossRefPubMed
20.
go back to reference Barros FC, Victora CG, Matijasevich A, Santos IS, Horta BL, Silveira MF, Barros AJ: Preterm birth, low birth weight, and intrauterine growth restriction in three birth cohorts in Southern Brazil: 1982, 1993 and 2004. Cad Saude Publica. 2008, 24: s390-8.CrossRefPubMed Barros FC, Victora CG, Matijasevich A, Santos IS, Horta BL, Silveira MF, Barros AJ: Preterm birth, low birth weight, and intrauterine growth restriction in three birth cohorts in Southern Brazil: 1982, 1993 and 2004. Cad Saude Publica. 2008, 24: s390-8.CrossRefPubMed
21.
go back to reference Panagopoulos P, Salakos N, Bakalianou K, Davou E, Iavazzo C, Paltoglou G, Liapis A: Adolescent pregnancy in a Greek public hospital during a six-year period (2000–2005)-a retrospective study. J pediatr Adolesc Gynecol. 2008, 21 (5): 265-8. 10.1016/j.jpag.2008.05.003.CrossRefPubMed Panagopoulos P, Salakos N, Bakalianou K, Davou E, Iavazzo C, Paltoglou G, Liapis A: Adolescent pregnancy in a Greek public hospital during a six-year period (2000–2005)-a retrospective study. J pediatr Adolesc Gynecol. 2008, 21 (5): 265-8. 10.1016/j.jpag.2008.05.003.CrossRefPubMed
22.
go back to reference Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC: Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA. 2006, 19;295 (15): 1809-23. 10.1001/jama.295.15.1809.CrossRef Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC: Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA. 2006, 19;295 (15): 1809-23. 10.1001/jama.295.15.1809.CrossRef
Metadata
Title
Impact of change in maternal age composition on the incidence of Caesarean section and low birth weight: analysis of delivery records at a tertiary hospital in Tanzania, 1999–2005
Authors
Projestine S Muganyizi
Hussein L Kidanto
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2009
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-9-30

Other articles of this Issue 1/2009

BMC Pregnancy and Childbirth 1/2009 Go to the issue