Adverse maternal outcomes among women who gave birth at public hospitals in eastern Ethiopia: a cross-sectional study.

IF 2.3 Q2 OBSTETRICS & GYNECOLOGY
Frontiers in global women's health Pub Date : 2025-03-28 eCollection Date: 2025-01-01 DOI:10.3389/fgwh.2025.1569815
Masresha Leta, Abera Kenay Tura, Haymanot Mezmur, Kasiye Shiferaw, Nega Assefa
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引用次数: 0

Abstract

Background: An adverse maternal outcome, such as anemia, postpartum hemorrhage, and postpartum eclampsia, poses a significant risk to women. While studies on the burden of adverse maternal outcomes have been conducted in various countries, including Ethiopia, many predictors beyond obstetric factors have not been fully explored. This study aimed to determine the magnitude and factors associated with adverse maternal outcomes among women who gave birth at selected public hospitals in eastern Ethiopia.

Methods: A hospital-based cross-sectional study was conducted among 2,608 randomly selected women who gave birth in six public hospitals in eastern Ethiopia from November 2023 to March 2024. Data were collected through face-to-face interviews and clinical chart reviews. Factors associated with adverse maternal outcomes were identified using bivariable and multivariable robust Poisson regression analyses. Adjusted relative risk (ARR) with a 95% confidence interval (CI) was used to report the strength of the association. The variables with a p-value of <0.05 were considered statistically significant.

Results: The magnitude of adverse maternal outcomes was 15.68% (95% CI: 14.70%-16.66%). A poor wealth index (ARR = 4.41; 95% CI: 3.46-5.62), having danger signs at admission (ARR = 1.86; 95% CI: 1.18-2.91), alcohol use during pregnancy (ARR = 1.86; 95% CI: 1.32-2.62), duration of labor ≥24 h (ARR = 1.69; 95% CI: 1.00-2.85), and maternal age greater than 35 years (ARR = 1.39; 95% CI: 1.03-1.86) increased the risk of adverse maternal outcomes. In contrast, folic acid intake during pregnancy (ARR = 0.47; 95% CI: 0.38-0.57), having partner support (ARR = 0.70; 95% CI: 0.59-0.83), and spontaneous vaginal delivery (ARR = 0.58; 95% CI: 0.49-0.68) reduced the risk of adverse maternal outcomes.

Conclusion: One in six women who gave birth in eastern Ethiopia experienced adverse maternal outcomes. This rate was determined to be moderate when compared to the WHO projections for lower- and middle-income countries and better than the higher averages reported by the WHO. Targeted intervention programs, such as targeted education and empowerment programs, and the strengthening of the community health worker program would help address socioeconomic disparities and improve early detection and management of danger signs during pregnancy, which would aid in averting the occurrence of adverse outcomes.

在埃塞俄比亚东部公立医院分娩的妇女的不良产妇结局:一项横断面研究。
背景:不良的产妇结局,如贫血、产后出血和产后子痫,对妇女构成重大风险。虽然在包括埃塞俄比亚在内的许多国家进行了关于不良产妇结局负担的研究,但尚未充分探讨产科因素以外的许多预测因素。本研究旨在确定在埃塞俄比亚东部选定的公立医院分娩的妇女不良孕产结果的程度和相关因素。方法:对2023年11月至2024年3月在埃塞俄比亚东部6家公立医院分娩的2,608名随机选择的妇女进行了以医院为基础的横断面研究。通过面对面访谈和临床图表回顾收集数据。使用双变量和多变量稳健泊松回归分析确定与不良产妇结局相关的因素。采用95%置信区间(CI)的校正相对危险度(ARR)来报告相关性的强度。结果变量的p值为:产妇不良结局的幅度为15.68% (95% CI: 14.70% ~ 16.66%)。贫穷财富指数(ARR = 4.41;95% CI: 3.46-5.62),入院时有危险迹象(ARR = 1.86;95% CI: 1.18-2.91),孕期饮酒(ARR = 1.86;95% CI: 1.32-2.62),分娩持续时间≥24 h (ARR = 1.69;95% CI: 1.00-2.85),且母亲年龄大于35岁(ARR = 1.39;95% CI: 1.03-1.86)会增加产妇不良结局的风险。相比之下,怀孕期间叶酸摄入量(ARR = 0.47;95% CI: 0.38-0.57),有伴侣支持(ARR = 0.70;95% CI: 0.59-0.83),阴道自然分娩(ARR = 0.58;95% CI: 0.49-0.68)降低了不良产妇结局的风险。结论:六分之一在埃塞俄比亚东部分娩的妇女经历了不良的产妇结局。与世卫组织对低收入和中等收入国家的预测相比,这一比率被确定为中等水平,优于世卫组织报告的较高平均水平。有针对性的干预方案,如有针对性的教育和赋权方案,以及加强社区卫生工作者方案,将有助于解决社会经济差距问题,改善怀孕期间危险迹象的早期发现和管理,这将有助于避免不良后果的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.70
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0.00%
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审稿时长
13 weeks
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