Prevalence and associated risk factors of ante-partum hemorrhage among Arab women in an economically fast growing society

Abstract

Objective: The aim of this study was to determine the prevalence and associated risk factors of antepartum hemorrhage (APH) in the third trimester of Arab women residing in Qatar and their neonatal outcome. Design and Setting: A prospective hospital-based study was conducted in the Womens Hospital and Maternity Clinics. Materials and Methods: The study was based on pregnant women in the third trimester from the first week of January 2010 to April 2011. A total of 2,056 pregnant women, who had any kind of maternal complications, were approached and 1,608 women (78.2) expressed their consent to participate in the study. The questionnaire covered variables related to socio-demographic factors, family history, medical history, maternal complications and neonatal outcome. Multiple logistic regressions were used to describe the association between socio-demographic factors and APH. Results: The overall prevalence of APH among Arab women residing in Qatar was 15.3 with 6.7 among Qataris and 8.6 among non-Qatari Arab women; the difference in ethnicities was not significant. Among maternal socio-demographic characteristics, lower education (primary or below AOR 1.72; 95CI 1.22-2.43, and intermediate education AOR 1.41; 95CI 0.88-2.26; P=0.005) compared to university education was significantly associated with APH. As for maternal biological characteristics, family history of G6PD (AOR 1.87; 95 CI 1.18-2.95; P=0.007) and family history of Downs Syndrome (AOR 1.88; 95CI 1.35-2.62; P=< 0.001) were significantly associated with APH at the multivariable level; family history of hypertension (OR 1.78; 95CI 1.30-2.44; P < 0.001) was significant at the univariate level. Neonatal outcomes as a result of APH included increased risk of Apgar score at 1 minutes < 7 (AOR 1.44; 95CI 1.12-2.02; P=0.04) and minor congenital anomaly (AOR 2.82; 95CI 1.39-5.71; P=0.004). Conclusion: Qatar has a high prevalence of APH. Poor education, family history of hypertension, G6PD and Downs syndrome were found to be significantly associated with increased risk of APH in Qatar. Neonates of APH are at significantly increased risk of adverse outcome. Thus it is essential that obstetricians are alerted to these risk factors for early detection and to decrease the negative effects of APH.