Improving maternal and infant mortality are key priorities in Kenya and internationally. This study aims to establish a hospital-based surveillance system for pregnant women so that the contribution of risk factors (HIV and other infections, maternal nutrition, sepsis, malaria and anaemia) to maternal and infant morbidity and mortality can be accurately assessed. All mothers who are admitted to Kilifi District Hospital will be invited to enrol in the study. Routine clinical data from maternal admissions for delivery will be systematically collected using a standardised admissions procedure. Analysis will be carried out for the risk factor effects of HIV, maternal nutrition, malaria infection, bacterial infection, and anaemia on maternal and infant outcomes after adjusting for other factors (mode of delivery, age, and parity etc). Subsequent morbidity and survival of mothers and infants, and the later consequences to children's health will be monitored through the Kilifi epi-DSS. Samples for research purposes will be collected for detailed future studies of particular pathogens and risk factors, such as malaria parasite strain, bacterial species and HIV-induced immunological impairment. This will be the first prospective study in sub-Saharan Africa (sSA) to assess the effect of these risk factors on both maternal and infant health together, and that considers both short and long term outcomes. Information generated by the study will be used by the maternity department in a rolling audit that will help improve care. The study will therefore improve care of new mothers and infants attending the Kilifi District Hospital as well as informing health planning so that future interventions for maternal and child health are targeted more effectively.
Study Type
OBSERVATIONAL
Enrollment
4,600
Kilifi District Hospital
Kilifi, Coast, Kenya
RECRUITINGMaternal mortality
Determine the effects of risk factors and obstetric events on maternal deaths (to 42 days).
Time frame: At delivery and follow up through DHS to 42 days
Perinatal mortality
Determine the effects of risk factors and obstetric events on perinatal mortality (stillbirth and deaths to 7 days of life); infant mortality to 60 days
Time frame: To 7 days post delivery
Maternal and Newborn long term survival
Follow up to 2 years after delivery
Time frame: ongoing
Maternal morbidity
Life threatening events and maternal conditions at delivery
Time frame: During admission (about 3 days)
Neonatal morbidity
Neonatal morbidity in terms of admission to the paediatric ward (and diagnosis).
Time frame: During admission (approx 2 weeks if admitted)
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