International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 1, pp: (179-183), Month: April 2020 - September 2020, Available at: www.researchpublish.com
The prevalence of adverse pregnancy and birth complications among elderly primigravidas in Kakamega County, Kenya MILLICENT AMBETSA Masinde Muliro University of Science and Technology, Kakamega, Kenya
Abstract: Maternal age at conception seems to have a significant correlation with pregnancy and childbirth outcomes. Classically, very young childbearing women and those over 35 years have been classified as high-risk categories for child bearing.. The specific objective of the study was to determine the prevalence of adverse pregnancy birth complications among elderly primigravidas in Kakamega County, Kenya. A cross sectional survey of childbearing women and selected hospital personnel in 3 selected hospitals and tertiary institutions in Kakamega County was carried out. Sampling strategies included purposive, quota and stratified sampling. The sample size was determined using Fishers formula, which was 177 childbearing women attending clinic, 177 child bearing women from tertiary institutions and 30 medical personnel. Data collection methods included structured questionnaires, focused group discussions, interview guides and observation checklists. . Qualitative methods were used to analyze data from focus group discussions and key informant interviews. SPSS was used to analyze quantitative data. Key results of the findings revealed that the prevalence of adverse complications occurred mainly in childbearing women from age 35 years and above. The complications included pre eclampsia, ante partum haemorrhage and premature rupture of membranes among others. The recommendations to mitigate the problem include health education to women on the dangers of late age pregnancy, development of government policies on access to quality maternal health services for elderly primigravidas and maternity protection in the work place. Keywords: prevalence, primigravidas, adverse, complications.
1. BACKGROUND While maternal survival has improved substantially worldwide since 1990, with 1.9% annual decline in mortality between 1990 and 2011, deaths continue to be concentrated in Sub-Saharan African and South Asian countries where the lifetime risk of a woman dying from pregnancy-related causes is about 100 times higher than that of a woman in a high income country (WHO et al, 2017). The past 50 years have seen immense transformations in the educational and the reproductive expectations of young people in the developing world. Investing in education is one of the most emphasized components of development (UNESCO, 2009). Late age pregnancies have been reported to result from extended education up to tertiary level, settling in employment, a desire for financial security, building a career among others (Freeman, 2002). Based on the information therefore, many women are opting to have babies late in life as opposed to the earlier generations and the risks of this cannot be ignored or overlooked because as a woman becomes older, the probability of becoming pregnant decreases leading to late age related complications or infertility. The current TFR of 3.9 for the whole country is the lowest ever recorded in Kenya (KDHS, 2014). In addition, the probability of having a miscarriage is higher and there is an increased risk of chromosomal abnormalities in the baby (Bewley, 2009). This is a potential disaster that is already in the making and an intervention needs to be taken to enable the society cope with this emerging trend. .While the global maternal mortality rate has been decreasing at a rate of 2.3 per cent, it is still less than half of the 5.5 per cent needed to achieve the three-quarter reduction required of the WHO sustainability goal. Moreover, large geographical inequalities persisted. For example, regionally, sub-Saharan Africa remained by far the one with highest MMR at 546 maternal deaths per 100,000 live births while the average in developed countries was just 12 maternal deaths per 100,000
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