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.

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