Length of hospital stay and its associated factors among women who gave birth by cesarean section in general hospitals of Sidama region, Ethiopia.

Abstract

Despite rising cesarean section (CS) rates in Ethiopia, evidence on determinants of postoperative length of hospital stay (LoS) remains scarce, particularly for rural general hospitals handling most deliveries. This study was aimed at assessing the length of hospital stay and its associated factors among women who undergo cesarean section in general hospitals of the Sidama region. An institution-based cross-sectional study was conducted among 505 post-CS mothers from 1 January to 20 February 2024. A multistage sampling method was followed to select the study respondents. Data was collected using a structured and pretested, interviewer-administered questionnaire. Data was collected using the Kobo Toolbox system and exported to Stata version 14.0 for management and analysis. Factors associated with the length of hospital stay were determined using a Poisson regression model. The factors associated with the outcome variable were identified using the adjusted risk ratio (ARR). Statistical significance was set at a p-value of less than 0.05. The median LoS post-CS was 4 days (interquartile range: 3-4). Significant predictors of prolonged LoS included maternal age (ARR = 1.014, 95% CI: 1.004-1.024), neonatal intensive care unit (NICU) admission (ARR = 1.31, 95% CI: 1.16-1.46), surgical site infection (ARR = 2.39, 95% CI: 1.88-3.04), and low postoperative hemoglobin (ARR = 0.94, 95% CI: 0.92-0.97). The median hospital stay after cesarean delivery in general hospitals of Sidama region was 4 days. Prolonged stays were associated with maternal age, NICU admission, surgical site infection, and low post-op hemoglobin. Targeting high-risk mothers with enhanced monitoring and wound care-alongside NICU-maternity service integration and safety-conscious discharge protocols-is recommended to accelerate recovery.