A critical analysis of preterm birth in a largely homogeneous community near Tygerberg Academic Hospital with a high prevalence of preterm birth

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dc.contributor.advisorOdendaal, Hendrik Johannesen_ZA
dc.contributor.advisorHall, David Raymonden_ZA
dc.contributor.authorBrink, Lucy Theresaen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Obstetrics and Gynaecology.en_ZA
dc.date.accessioned2022-11-19T13:06:34Zen_ZA
dc.date.accessioned2023-01-16T12:48:00Zen_ZA
dc.date.available2022-11-19T13:06:34Zen_ZA
dc.date.available2023-01-16T12:48:00Zen_ZA
dc.date.issued2022-11en_ZA
dc.descriptionThesis (PhD) Stellenbosch University, 2022.en_ZA
dc.description.abstractENGLISH ABSTRACT: There is a high priority to address the heavy burden of preterm birth (PTB) on a low- to middle- class community in the Western Cape Province of South Africa (SA), where the Safe Passage Study (SPS) by the PASS Network was conducted. The latter study was undertaken to determine the role of alcohol consumption in stillbirths and sudden infant deaths. We documented a high rate (13.8%) of PTB in that community. Preterm birth (birth before 37 weeks) is one of the most common causes of perinatally related deaths at Tygerberg Academic Hospital (TAH), the tertiary referral hospital for the community. Complications of PTB also account for 75% of perinatal mortalities and more than 50% of chronic infant morbidities and therefore remains one of the greatest challenges in obstetrics. Perinatal outcome is particularly susceptible to socioeconomic conditions that have profound effects on the health of individuals and communities. SA has one of the highest levels of alcohol consumption (including binge drinking i.e. drinking four or more standard drinks during one sitting) as well as concomitant smoking in certain communities. Individuals with low socioeconomic status experience greater exposure to stress and are more likely to engage in risk-taking behaviours such as smoking, drinking and drug use during pregnancy, which may contribute to adverse birth outcomes. Despite the attention given to PTB in medical research, the aetiology remains largely unexplained, and placental pathology may illuminate the clinical understanding thereof. Increasing evidence indicates that placental dysfunction is an important risk factor for PTB, but contexts differ and information from low-income-countries is lacking.en_ZA
dc.description.abstractAFRIKAANS OPSOMMING: Inleiding: Dit is ʼn hoë prioriteit om die swaar las van voortydse of premature kraam (kraam voor 37 weke) in ʼn lae- tot middelklas gemeenskap in die Wes Kaap Provinsie van Suid Afrika (SA) aan te preek, waar die Safe Passage Study (SPS), deur die PASS Network, gedoen is om die rol van alkoholgebruik in stilgeboortes en skielike babadood (wiegiesterfte) te probeer vasstel. Ons het ʼn hoë voortydse kraamkoers (13.8%) in hierdie gemeenskap gevind. Voortydse kraam is een van die hoofoorsake van perinatale sterftes by Tygerberg Akademiese Hospitaal (TAH), die tersiêre verwysings hospitaal vir die gemeenskap. Komplikasies van voortydse kraam dra by tot 75% van perinatale sterftes en meer as 50% van kroniese babasiektes, en derhalwe bly dit een van die grootste uitdagings in verloskunde. Perinatale uitkomste is in besonder onderhewig aan sosioëkonomiese toestande, wat diepgaande effekte het op die gesondheid van individue en gemeenskappe. SA het een van die hoogste vlakke van alkoholgebruik (insluitend fuifdrink, dit is vier of meer standaard drankies per geleentheid) asook gepaardgaande rook in sekere gemeenskappe. Individue met lae sosioëkonomiese status (SES) ondervind groter blootstelling aan stres en is dus meer geneig om betrokke te raak in hoë risikogedrag soos rook, drink en dwelmgebruik tydens swangerskap, wat dan tot nadelige geboorte-uitkomste kan bydra. Ten spyte van al die aandag aan voortydse kraam in mediese navorsing, bly die etiologie daarvan steeds grootliks onverklaarbaar en mag plasentale patologie die kliniese begrip daarvan beter verduidelik. Toenemende bewyse dui daarop dat plasentale ontoereikenheid ʼn belangrike risikofaktor is vir voortydse kraam, maar inligting uit lae inkomstelande ontbreek nog.af_ZA
dc.description.versionDoctoralen_ZA
dc.format.extent217 pages : illustrationsen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/126060en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectPremature labor -- Western Cape (South Africa)en_ZA
dc.subjectPregnant women -- Alcohol use -- Western Cape (South Africa)en_ZA
dc.subjectStillbirth -- Western Cape (South Africa)en_ZA
dc.subjectSudden infant death syndrome -- Western Cape (South Africa)en_ZA
dc.subjectUCTDen_ZA
dc.titleA critical analysis of preterm birth in a largely homogeneous community near Tygerberg Academic Hospital with a high prevalence of preterm birthen_ZA
dc.typeThesisen_ZA
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