Adverse pregnancy outcomes and associated maternal and infection-related factors in a rural malaria-endemic setting in Western Kenya
Abstract
IntroductionMaternal health during pregnancy is critical for favorable birth outcomes and long-term wellbeing of both mothers and infants. Women in rural, malaria-endemic regions face unique biological and socioeconomic challenges that may increase the risk of adverse pregnancy outcomes (APOs). This study investigated the proportions and determinants of APOs among pregnant women attending antenatal care at Webuye sub-County Hospital in Western Kenya, a rural malaria-endemic setting.MethodsA secondary data analysis was conducted utilizing previously collected data of 302 women enrolled at different gestational ages and followed through delivery in a prospective cohort study. Maternal demographic, clinical, and infection-related factors were assessed, and associations with APOs were evaluated using chi-square tests and multivariable logistic regression.ResultsMaternal age and gestational age at enrollment were significantly associated with malaria history (P-value <0.001). Maternal anemia (9.9%), abortion (6.3%), preterm birth (4.4%), miscarriage (1.7%), low birth weight (3.4%), stillbirth (7.6 per 1,000 births), neonatal death (3.8 per 1,000 live births) occurred at varying frequencies, indicating a range of adverse outcomes in the study cohort. Younger mothers (<20 years) and older mothers (>35 years) had a higher proportion of anemia (P-value = 0.026) than those aged 21-35 years, and reported malaria history was significantly associated with maternal anemia at enrolment (p-value = 0.02). An additional analysis using microscopy-confirmed malaria status showed a similar difference in hemoglobin levels between microscopy-positive and microscopy-negative participants (p-value < .001). Abnormal urinalysis findings suggestive of urinary tract infection were significantly associated with low birth weight (p-value = 0.031). No significant associations were found between APOs and infant sex, parity, gravidity, or maternal ABO blood type.DiscussionThese findings describe the proportions of the occurrence of adverse outcomes in this rural population and identify maternal age, malaria exposure and abnormal urinalysis results as factors associated with selected outcomes. Strengthening malaria prevention, urinary infection screening, and encouraging early antenatal care attendance are critical to improving maternal and neonatal outcomes. Targeted interventions for adolescent and older mothers, along with enhanced point-of-care diagnostics, may reduce preventable complications in similar resource-limited, malaria-endemic settings.
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BibTeX
@article{kituyi2026adverse,
title = {{Adverse pregnancy outcomes and associated maternal and infection-related factors in a rural malaria-endemic setting in Western Kenya}},
author = {Sarah Naulikha Kituyi and Alfred Owino Odongo and Rachael Wachuka and Shadrack Wambua and Francis Kobia and Jesse Gitaka and Bernard N. Kanoi},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1954098},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1954098},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Adverse pregnancy outcomes and associated maternal and infection-related factors in a rural malaria-endemic setting in Western Kenya
AU - Sarah Naulikha Kituyi
AU - Alfred Owino Odongo
AU - Rachael Wachuka
AU - Shadrack Wambua
AU - Francis Kobia
AU - Jesse Gitaka
AU - Bernard N. Kanoi
PY - 2026
DA - 2026/11/02
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1954098
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1954098
AB - IntroductionMaternal health during pregnancy is critical for favorable birth outcomes and long-term wellbeing of both mothers and infants. Women in rural, malaria-endemic regions face unique biological and socioeconomic challenges that may increase the risk of adverse pregnancy outcomes (APOs). This study investigated the proportions and determinants of APOs among pregnant women attending antenatal care at Webuye sub-County Hospital in Western Kenya, a rural malaria-endemic setting.MethodsA secondary data analysis was conducted utilizing previously collected data of 302 women enrolled at different gestational ages and followed through delivery in a prospective cohort study. Maternal demographic, clinical, and infection-related factors were assessed, and associations with APOs were evaluated using chi-square tests and multivariable logistic regression.ResultsMaternal age and gestational age at enrollment were significantly associated with malaria history (P-value <0.001). Maternal anemia (9.9%), abortion (6.3%), preterm birth (4.4%), miscarriage (1.7%), low birth weight (3.4%), stillbirth (7.6 per 1,000 births), neonatal death (3.8 per 1,000 live births) occurred at varying frequencies, indicating a range of adverse outcomes in the study cohort. Younger mothers (<20 years) and older mothers (>35 years) had a higher proportion of anemia (P-value = 0.026) than those aged 21-35 years, and reported malaria history was significantly associated with maternal anemia at enrolment (p-value = 0.02). An additional analysis using microscopy-confirmed malaria status showed a similar difference in hemoglobin levels between microscopy-positive and microscopy-negative participants (p-value < .001). Abnormal urinalysis findings suggestive of urinary tract infection were significantly associated with low birth weight (p-value = 0.031). No significant associations were found between APOs and infant sex, parity, gravidity, or maternal ABO blood type.DiscussionThese findings describe the proportions of the occurrence of adverse outcomes in this rural population and identify maternal age, malaria exposure and abnormal urinalysis results as factors associated with selected outcomes. Strengthening malaria prevention, urinary infection screening, and encouraging early antenatal care attendance are critical to improving maternal and neonatal outcomes. Targeted interventions for adolescent and older mothers, along with enhanced point-of-care diagnostics, may reduce preventable complications in similar resource-limited, malaria-endemic settings.
SN - 2296-2565
ER -