Browsing by Author "Lavin, T."

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Burden and outcomes of postpartum haemorrhage in Nigerian referral-level hospitals.
(2024) Adebayo, T.; Adefemi, A.; Adewumi, I.; Akinajo, O.; Akinkunmi, B.; Awonuga, D.; Aworinde, O.; Ayegbusi, E.; Dedeke, I.; Fajolu, I.; Imam, Z.; Jagun, O.; Kuku, O.; Ogundare, E.; Oluwasola, T.; Oyeneyin, L.; Adebanjo-Aina, D.; Adenuga, E.; Adeyanju, A.; Akinsanya, O.; Campbell, I.; Kuti, B.; Olofinbiyi, B.; Salau, Q.; Tongo, O.; Ezekwe, B.; Lavin, T.; Oladapo, O. T.; Tukur, J.; Adesina, O.
Objective: To determine the prevalence of primary postpartum haemorrhage (PPH), risk factors, and maternal and neonatal outcomes in a multicentre study across Nigeria. Design: A secondary data analysis using a cross-sectional design. Setting: Referral-level hospitals (48 public and six private facilities). Population: Women admitted for birth between 1 September 2019 and 31 August 2020. Methods: Data collected over a 1-year period from the Maternal and Perinatal Database for Quality, Equity and Dignity programme in Nigeria were analysed, stratified by mode of delivery (vaginal or caesarean), using a mixed-effects logistic regression model. Main outcome measures: Prevalence of PPH and maternal and neonatal outcomes. Results: Of 68 754 women, 2169 (3.2%, 95% CI 3.07%–3.30%) had PPH, with a prevalence of 2.7% (95% CI 2.55%–2.85%) and 4.0% (95% CI 3.75%–4.25%) for vaginal and caesarean deliveries, respectively. Factors associated with PPH following vaginal delivery were: no formal education (aOR 2.2, 95% CI 1.8–2.6, P < 0.001); multiple pregnancy (aOR 2.7, 95% CI 2.1–3.5, P < 0.001); and antepartum haemorrhage (aOR 11.7, 95% CI 9.4–14.7, P < 0.001). Factors associated with PPH in a caesarean delivery were: maternal age of >35 years (aOR 1.7, 95% CI 1.5–2.0, P < 0.001); eferral from informal setting (aOR 2.4, 95% CI 1.4–4.0, P = 0.002); and antepartum haemorrhage (aOR 3.7, 95% CI 2.8–4.7, P < 0.001). Maternal mortality occurred in 4.8% (104/2169) of deliveries overall, and in 8.5% (101/1182) of intensive care unit admissions. One-quarter of all infants were stillborn (570/2307), representing 23.9% (429/1796) of neonatal intensive care unit admissions. Conclusions: A PPH prevalence of 3.2% can be reduced with improved access to skilled birth attendants.
Determinants and outcomes of preterm births in Nigerian tertiary facilities.
(2024) Fajolu, I. B.; Dedeke, I. O. F.; Oluwasola, T. A.; Oyeneyin, L.; Imam, Z.; Ogundare, E.; Campbell, I.; Akinkunmi, B.; Ayegbusi, E. O.; Agelebe, E.; Adefemi, A. K.; Awonuga, D.; Jagun, O.; Salau, Q.; Kuti, B.; Tongo, O. O.; Adebayo, T.; Adebanjo-Aina, D.; Adenuga, E.; Adewumi, I.; Lavin, T.; Tukur, T.; Adesina, O.
Objective: To describe the incidence, and sociodemographic and clinical factors associated with preterm birth and perinatal mortality in Nigeria. Design: Secondary analysis of data collected through the Maternal Perinatal Database for Quality, Equity and Dignity (MPD-4-QED) Programme. Setting: Data from births in 54 referral-level hospitals across Nigeria between 1 September 2019 and 31 August 2020. Population: A total of 69 698 births. Methods: Multilevel modelling was used to determine the factors associated with preterm birth and perinatal mortality. Outcome measures: Preterm birth and preterm perinatal mortality. Results: Of 62 383 live births, 9547 were preterm (153 per 1000 live births). Maternal age (<20 years – adjusted odds ratio [aOR] 1.52, 95% CI 1.36–1.71; >35 years – aOR 1.23, 95% CI 1.16–1.30), no formal education (aOR 1.68, 95% CI 1.54–1.84), partner not gainfully employed (aOR 1.94, 95% CI 1.61–2.34) and no antenatal care (aOR 2.62, 95% CI 2.42–2.84) were associated with preterm births. Early neonatal mortality for preterm neonates was 47.2 per 1000 preterm live births (451/9547). Father's occupation (manual labour aOR 1.52, 95% CI 1.20–1.93), hypertensive disorders of pregnancy (aOR 1.37, 95% CI 1.02–1.83), no antenatal care (aOR 2.74, 95% CI 2.04–3.67), earlier gestation (28 to <32 weeks – aOR 2.94, 95% CI 2.15–4.10; 32 to <34 weeks – aOR 1.80, 95% CI 1.3–2.44) and birthweight <1000 g (aOR 21.35, 95% CI 12.54–36.33) were associated with preterm perinatal mortality. Conclusions: Preterm birth and perinatal mortality in Nigeria are high. Efforts should be made to enhance access to quality health care during pregnancy, delivery and the neonatal period, and improve the parental socio-economic status.
The health of internally displaced children in sub-Saharan Africa: a scoping review
(BMJ Publishing Group Ltd, 2020) Salami, B.; Iwuagwu, S.; Amodu, O.; Tulli, M.; Ndikom, C.; Gommaa, H.; Lavin, T.; Kariwo, M.
Background: Internally displaced children are those who have been forced to flee their homes due to severe unfavourable conditions (war, violence or disasters) but have not crossed international borders. Emerging research shows these children face multiple health challenges. However, we found no review focused solely on the health of such internally displaced children. Thus, this review sought to examine what is known about their health and their health concerns. Methods: A scoping review of the literature was conducted. A total of 10 databases were searched in January 2019, yielding 6602 articles after duplicates were eliminated. Two research assistants independently selected articles that met inclusion criteria. A numerical summary and thematic analysis were conducted to facilitate data extraction and data analysis. Results: A total of 25 articles met the inclusion criteria, including 16 quantitative, 6 qualitative and 3 mixed methods studies. The findings reveal elevated mental health problems and infectious diseases in this population. Findings on the nutritional status of internally displaced children as a broad group are mixed, with some studies showing poorer nutritional status among the children in this group and others showing poorer nutritional health status among host society children. Internally displaced children also experience challenges with access to health services. Premigration factors (trauma) and postmigration factors (humanitarian assistance on displacement) all contribute to the health of internally displaced children. Conclusion: Findings provide insight into the complex array of factors influencing the health of internally displaced children. More intervention studies are required to address the needs of this population.