{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:31:01Z","timestamp":1757615461650,"version":"3.44.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T00:00:00Z","timestamp":1749772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp;amp; Obste"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the association between cultural abdominal massage (CAM) in pregnancy and adverse maternal and perinatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective cohort study, eligible term pregnant women who underwent CAM (exposed, <jats:italic>n<\/jats:italic>\u2009=\u2009160) and those who did not undergo CAM (unexposed, <jats:italic>n<\/jats:italic>\u2009=\u2009160) in the index pregnancy were enrolled during labor. Participants were followed up and immediate adverse maternal outcomes, including abruptio placenta, primary postpartum hemorrhage (PPH), uterine rupture, cesarean hysterectomy, admission to a high\u2010dependency unit (HDU), and maternal death, and adverse perinatal outcomes, including intrauterine fetal demise (IUFD), stillbirth, 5\u2010min Apgar score below 7, admission to neonatal HDU, and neonatal death, were evaluated within the first 72\u2009h of delivery. The association between CAM and adverse maternal and perinatal outcomes was assessed using binomial logistic regression adjusted for potential confounders to obtain adjusted risk ratios (aRRs) with corresponding 95% confidence intervals (CIs). Statistical significance was two\u2010tailed at <jats:italic>P<\/jats:italic>\u2009\u2264\u20090.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with those who did not undergo CAM, women who underwent CAM in the index pregnancy had increased risk of primary PPH (adjusted risk ratio [ARR] 3.04, 95% CI 2.49\u20133.72, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), uterine rupture (aRR 1.61, 95% CI 1.04\u20132.49, <jats:italic>P<\/jats:italic>\u2009=\u20090.031), stillbirth (aRR 1.54, 95% CI 1.09\u20132.16, <jats:italic>P<\/jats:italic>\u2009=\u20090.013) and 5\u2010min Apgar score below 7 (aRR 2.11, 95% CI 1.78\u20132.51, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). There was no association between CAM and abruptio placenta, cesarean hysterectomy, admission to HDU, or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Women who underwent CAM were at increased risk of primary PPH, uterine rupture, stillbirth, and 5\u2010min Apgar score below 7.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.70304","type":"journal-article","created":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T10:39:45Z","timestamp":1749811185000},"page":"1302-1308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cultural abdominal massage in pregnancy and obstetric outcomes in a sub\u2010county hospital in Kenya"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5296-2437","authenticated-orcid":false,"given":"Rukia","family":"Gang'ombe","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Nairobi  Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2049-3100","authenticated-orcid":false,"given":"Alfred","family":"Osoti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Nairobi  Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zahida","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Nairobi  Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8766-5870","authenticated-orcid":false,"given":"Omondi","family":"Ogutu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Nairobi  Nairobi Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,13]]},"reference":[{"volume-title":"Trends in Maternal Mortality 2000 to 2017: Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division","year":"2019","author":"World Health Organization","key":"e_1_2_11_2_1"},{"key":"e_1_2_11_3_1","unstructured":"Trends in maternal mortality 2000 to 2020: estimates by WHO UNICEF UNFPA World Bank Group and UNDESA\/Population Division. 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