{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:13:32Z","timestamp":1784643212907,"version":"3.55.0"},"reference-count":70,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["SFRH\/BD\/117037\/2016"],"award-info":[{"award-number":["SFRH\/BD\/117037\/2016"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Newborns with one-or-more adverse birth outcomes (ABOs) are at greater risk of mortality or long-term morbidity with health impacts into adulthood. Hence, identifying ABO-associated factors is crucial for devising relevant interventions. For this study, ABOs were defined as prematurity (PTB) for gestational age &lt;37 weeks, low birth weight (LBW) &lt;2.5 kg, macrosomia &gt;4 kg, asphyxia for a 5-minute Apgar score &lt;7, congenital anomalies, and neonatal sepsis. This study aimed to assess factors associated with ABOs among babies delivered at the only hospital of Sao Tome &amp; Principe (STP), a resource-constrained sub-Saharan-Central African country.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A hospital-based unmatched case\u2012control study was conducted among newborns from randomly selected mothers. Newborns with one-or-more ABO were the cases (ABO group), while healthy newborns were the controls (no-ABO group). Data were collected by a face-to-face interview and abstracted from antenatal care (ANC) pregnancy cards and medical records. Multivariable logistic regression analysis was performed to identify ABO-associated factors considering a level of significance of \u03b1 = 0.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 519 newborns (176 with ABO and 343 no-ABO) were enrolled. The mean gestational age and birthweight of cases and controls were 36 (SD = 3.7) weeks with 2659 (SD = 881.44) g and 39.6 (SD = 1.0) weeks with 3256 (SD = 345.83) g, respectively. In the multivariable analysis, twin pregnancy [aOR 4.92, 95% CI 2.25\u201310.74], prolonged rupture of membranes [aOR 3.43, 95% CI 1.69\u20136.95], and meconium- fluid [aOR 1.59, 95% CI 0.97\u20132.62] were significantly associated with ABOs. Eight or more ANC contacts were found to be protective [aOR 0.33, 95% CI 0.18\u20130.60, p&lt;0.001].<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Modifiable factors were associated with ABOs in this study and should be considered in cost-effective interventions. The provision of high-quality ANC should be a priority. Twin pregnancies and intrapartum factors such as prolonged rupture of membranes and meconium-stained amniotic fluid are red flags for ABOs that should receive prompt intervention and follow-up.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0276348","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T17:30:55Z","timestamp":1688751055000},"page":"e0276348","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Adverse birth outcomes and associated factors among newborns delivered in Sao Tome &amp; Principe: A case\u2012control study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8042-0846","authenticated-orcid":true,"given":"Alexandra","family":"Vasconcelos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swasilanne","family":"Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Bandeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7421-8550","authenticated-orcid":true,"given":"Marta","family":"Alves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Lu\u00edsa","family":"Papoila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filomena","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria C\u00e9u","family":"Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,7,7]]},"reference":[{"key":"pone.0276348.ref001","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/1471-2393-14-90","article-title":"Adverse birth outcomes among deliveries in Gonder university hospital, Northwest Ethiopia","volume":"14","year":"2014","journal-title":"BMC Pregnancy Childbirth"},{"issue":"6","key":"pone.0276348.ref002","doi-asserted-by":"crossref","first-page":"e0000218","DOI":"10.1371\/journal.pgph.0000218","article-title":"Large gains in schooling and income are possible from minimizing adverse birth outcomes in 121 low- and middle-income countries: A modelling study","volume":"2","author":"MM Blakstad","year":"2022","journal-title":"PLOS Glob Public Health"},{"key":"pone.0276348.ref003","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1471-0528.2009.02328.x","article-title":"Newborn survival in low resource settings\u2014are we delivering?","volume":"116","author":"JE Lawn","year":"2009","journal-title":"BJOG: An International Journal of Obstetrics & Gynaecology"},{"key":"pone.0276348.ref004","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1186\/s12978-018-0631-3","article-title":"Prevalence of adverse birth outcome and associated factors among women who delivered in Hawassa town governmental health institutions, South Ethiopia, in 2017","volume":"15","author":"Kassa Tsegaye","year":"2018","journal-title":"Reprod Health"},{"key":"pone.0276348.ref005","doi-asserted-by":"crossref","first-page":"e042423","DOI":"10.1136\/bmjopen-2020-042423","article-title":"Prevalence and risk factors of adverse birth outcomes in the Pacific Island region: a scoping review protocol","volume":"11","author":"LSK Kaforau","year":"2021","journal-title":"BMJ Open"},{"key":"pone.0276348.ref006","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.pmedr.2018.05.011","article-title":"Birth history as a predictor of adverse birth outcomes: Evidence from state vital statistics data","volume":"11","author":"D Su","year":"2018","journal-title":"Preventive medicine reports"},{"key":"pone.0276348.ref007","first-page":"1","article-title":"Is birth weight associated with blood pressure among African children and adolescents? 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