Clinical Overview of Prolonged Pregnancies and Early Neonatal Well-Being in Cameroon: Pilot Case-Control Study at the Laquintinie Hospital in Douala

Abstract

Introduction: A pregnancy is said to be “prolonged” according to the National College of French Gynecologists and Obstetricians (NCFGO) from a gestational age greater than 41 + 0 weeks. This purely chronological definition of prolonged pregnancy is associated with an increase in maternal-fetal morbidity and mortality. Objective: This study aimed to study the early obstetric and neonatal outcome of these pregnancies in our environment to improve obstetric surveillance and neonatal well-being. Method: To this end, we conducted a cross-sectional analytical study with prospective collection of data over a period of 5 months from January 7, 2020 to May 30, 2020 at the maternity ward of Laquintinie Hospital in Douala. We defined prolonged pregnancy according to NCFGO as gestational age greater than 41 + 0 weeks. The parturients were divided into two groups. We included the pregnant women whose gestational age was greater than 41 weeks in the group of prolonged pregnancies according to the date of the last period and/or the obstetric ultrasound of the first trimester and the pregnant women whose gestational age was between 37 weeks and 41 weeks in the group of non-prolonged pregnancies. The analysis was carried out using Epi-Info 7.2.2.1 and SPSS version 20.0 software. The chi2 test was used to compare variables. A p-value less than 0.05 was considered statistically significant. Results: During the study period, we recorded 58 cases of prolonged pregnancy out of 666 deliveries, i.e. a frequency of 8.7%. We did not identify socio-demographic variables associated with prolonged pregnancy in our study. Family history of prolonged pregnancy (OR = 4.4 [95% CI: 1.6 - 12.4], p = 0.003) and personal history of prolonged pregnancy (OR = 3.5 [95% CI: 1.0 - 12.0], p = 0.044) were associated clinical variables. Maternal and neonatal complications were: cesarean section (OR = 2.2 [95% CI: 1.2 - 4.1], p = 0.008), prolonged duration of labor (OR = 3.6 [95% CI: 1.0 - 12.5], p =0 .039), signs of post-maturity (OR = 25.1 [95% CI: 3.0 - 205.7], p = 0.002), chronic fetal distress and acute fetal distress (OR = 3.3 [95% CI: 1.6 - 6.9], p = 0.001). Given the nature of family and personal history associated with prolonged pregnancy, it is important to look for it during the first prenatal consultations.