Cultural abdominal massage in pregnancy and obstetric outcomes in a sub-county hospital in Kenya.

OBJECTIVE

To determine the association between cultural abdominal massage (CAM) in pregnancy and adverse maternal and perinatal outcomes.

METHODS

In this prospective cohort study, eligible term pregnant women who underwent CAM (exposed, n = 160) and those who did not undergo CAM (unexposed, n = 160) 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-dependency unit (HDU), and maternal death, and adverse perinatal outcomes, including intrauterine fetal demise (IUFD), stillbirth, 5-min Apgar score below 7, admission to neonatal HDU, and neonatal death, were evaluated within the first 72 h 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-tailed at P ≤ 0.05.

RESULTS

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 2.49-3.72, P < 0.001), uterine rupture (aRR 1.61, 95% CI 1.04-2.49, P = 0.031), stillbirth (aRR 1.54, 95% CI 1.09-2.16, P = 0.013) and 5-min Apgar score below 7 (aRR 2.11, 95% CI 1.78-2.51, P < 0.001). There was no association between CAM and abruptio placenta, cesarean hysterectomy, admission to HDU, or death.

CONCLUSION

Women who underwent CAM were at increased risk of primary PPH, uterine rupture, stillbirth, and 5-min Apgar score below 7.