Risks of severe, avoidable maternal and neonatal complications at birth are increased if the birth occurs before arrival at the health facility and in the absence of skilled birth attendants. Birth Before Arrival (BBA) is a preventable phenomenon still common in modern-day practice despite extensive improvements made in obstetric care and in accessibility to healthcare in South Africa. This study aimed to determine the risk factors and outcomes in mothers and babies associated with being born before arrival at hospitals.
A prospective case control study design was conducted. All BBAs presenting to the hospitals in Nkangala District between November 2015 and February 2016 were included and compared to a consecutive hospital delivery occurring immediately after the arrival of each BBA. T-tests and chi square tests were used to analyse the differences between the groups and a binary logistic regression analysis used to determine predictors of BBAs. All statistical analysis were done using STATA version 14 using a 5% decision level and a 95% confidence interval.
During the study period, 4397 in-facility births and 201 BBAs were recorded, 78 BBAs and 75 controls were investigated in this study. The district BBA prevalence was 4.6%. Risk factors identified in mothers of BBAs were: single mothers (83.3% vs 69.3%; p = 0.04); residing in an informal settlement (23.1% vs 5.3%; p = 0.002); and higher gravidity with plurigravida significantly more (60.3% vs 32.5%; p < 0.0001). A prevalent maternal complication in cases was haemorrhage due to retained placenta. Most neonates were born alive with a higher proportion of cases experiencing perinatal complications such as respiratory distress, hypothermia and asphyxia. No significant differences in maternal age, employment status and immediate birth outcomes were found. Residing in informal settlements, higher gravidity, unplanned pregnancy, low birth weight and unbooked were found to predict the occurrence of BBAs.
Although no significant numbers of mortalities were recorded in this study, service delivery interventions targeting the reduction of BBAs are needed so as to minimise the morbidity experienced by the group.
Parag N, McKerrow NH, Naby F. Profile of babies born before arrival at hospital in a peri-urban setting. SAJCH South African J Child Health. 2014;8(2):45–9. CrossRef
CHIRAGDIN DT. Effect of giving birth before arrival ( Bba ) on pregnancy outcome among booked mothers at coast submitted by as part of Fulfilment for the degree of master of medicine in obstetrics and Gynaecology, University of Nairobi February 2013. 2013;(February):1–52.
UNICEF. The state of World’s children 2009. UNICEF: UNICEF; 2009. p. 168. https://www.unicef.org/sowc09/. Accessed Mar 2016
United nationThe Millenium Development Goals Report 2014. The Millenium development goals report 2014. New York: United Nations [Internet]; 2014. p. 32. http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG. Accessed Nov 2015
Potter PC, Pelteret R, Reynolds L, Motala A, Kibel MA. Born before arrival. South African Med J. 1984;66(Sept):377–80.
South African DHIS database; 2015. p. 4–6. https://www.dhis.org/
Bassingthwaighte MK, Ballot DE. Outcomes of babies born before arrival at a tertiary hospital in Johannesburg, South Africa. SAJCH Novemb. 2013;7(4):139–45.
Lloyd LG. Neonatal mortality in South Africa: How are we doing and can we do better? S Afr Med J. 2013;103(8):518–9.
Pattinson RC. In: Pattinson R, editor. Saving babies 2010–2011 : eighth report on perinatal care in South Africa. 8th report. Pretoria, South Africa: Tshepesa Press; 2013. p. 1–41.
Wagstaff A, Claeson M, Hecht RM, Gottret P. Millennium development goals for Health : what will it take to accelerate Progress ? Heal (San Fr. 2003;Chapter 9 (Dc):181–194.
Al-amoudi S, Bahnassy AA. Maternal characteristics of deliveries before arrival to hospital in bisha, Saudi Arabia. Bahrain Med Bull. 1995;17(2):2–5.
National Department of Health SA. The 2012 National Antenatal Sentinel HIV & Herpes Simplex Type-2 prevalence survey in South Africa. 2012. https://www.health-e.org.za/wp-content/uploads/2014/05/ASHIVHerp_Report2014_22May2014.pdf.
Villar J, Bergsjo P. WHO programme to map best reproductive health practices. Geneva: WHO; 2002. p. 1–42. http://apps.who.int/iris/bitstream/10665/42513/1/WHO_RHR_01.30.pdf
Scott T, Esen UI. Unplanned out of hospital births--who delivers the babies? Ir Med J. 2005;98(3):70–2. PubMed
- Maternal characteristics and birth outcomes resulting from births before arrival at health facilities in Nkangala District, South Africa: a case control study
Donald H. A. Amoko
- BioMed Central
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