Adverse maternal and neonatal outcomes in Northern Sudan: the role of antenatal care and socioeconomic inequities in war.

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Reproductive Health Pub Date : 2025-10-07 DOI:10.1186/s12978-025-02129-4

Suodad Elhassan, Marwa Osman, Ayat Altaher, Reem Mohamedalhassan Ahmed Mohamed, Saja Salah, Swsan Elsharif, Elshimaa Yousif

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引用次数: 0

Abstract

Background: The World Health Organization (WHO) has recommended increasing the minimum number of antenatal care (ANC) contacts from four to eight. High rates of maternal and neonatal complications and low ANC coverage are significant concerns in Sudan, especially after the war erupted. This study investigated the patterns of adverse maternal and neonatal outcomes and their correlation with ANC use and socioeconomic profile.

Methods: This cross-sectional study was conducted on 267 postpartum women using convenience sampling in three public hospitals and one private clinic in Merowe locality, Northern Sudan. Structured interviews were conducted to collect data on socioeconomic and maternal characteristics, ANC use, and adverse maternal and neonatal outcomes. Descriptive, bivariate, and multivariate analyses were performed using Statistical Package for Social Science (SPSS).

Results: The perinatal death rate was 3.4%. Preterm delivery and neonatal ICU admission rates were 10.1% and 7.1%, respectively. Adverse maternal outcomes occurred in 26.2% of the cases, with gestational hypertension (7.5%) and dystocia (4.1%) being the most prevalent. Displaced women showed higher rates of eclampsia and preeclampsia (p value = 0.002). Predictors of adverse maternal outcomes were gravidity of more than five (Adjusted Odds Ratio 2.55; 95% CI 1.04-6.23), rural residence (AOR = 2.52; 95% CI 1.25-5.12), and history of adverse events (AOR = 3.15; 95% CI 1.67-5.92). Fewer than four ANC contacts were associated with more perinatal deaths (p value = 0.032), while ≥ 8 visits did not improve the outcomes.

Conclusions: The rate of adverse maternal outcomes was high and was influenced by obstetric and socioeconomic profiles. Attending at least four ANC visits was significantly associated with better birth outcomes. Addressing the social determinants of health and implementing screening programs for high-risk women are recommended.

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苏丹北部不利的孕产妇和新生儿结局：产前保健的作用和战争中的社会经济不平等。

背景：世界卫生组织（世卫组织）建议将产前保健（ANC）接触的最低次数从4次增加到8次。在苏丹，特别是在战争爆发后，产妇和新生儿并发症的高发率和低ANC覆盖率是令人关切的重大问题。本研究调查了孕产妇和新生儿不良结局的模式及其与ANC使用和社会经济状况的相关性。方法：采用方便抽样的方法，对苏丹北部Merowe地区3家公立医院和1家私立诊所的267名产后妇女进行横断面研究。进行结构化访谈以收集有关社会经济和孕产妇特征、ANC使用以及孕产妇和新生儿不良结局的数据。使用社会科学统计软件包（SPSS）进行描述性、双变量和多变量分析。结果：围产儿死亡率为3.4%。早产儿和新生儿ICU住院率分别为10.1%和7.1%。不良产妇结局发生率为26.2%，其中妊娠期高血压（7.5%）和难产（4.1%）最为常见。流离失所妇女子痫和先兆子痫的发生率较高（p值= 0.002）。不良产妇结局的预测因子为妊娠超过5个（校正优势比2.55;95% CI 1.04-6.23）、农村居住（AOR = 2.52; 95% CI 1.25-5.12）和不良事件史（AOR = 3.15; 95% CI 1.67-5.92）。少于4次ANC接触与更多的围产期死亡相关（p值= 0.032），而≥8次ANC接触并没有改善结果。结论：产妇不良结局发生率高，并受产科和社会经济状况的影响。参加至少四次ANC访问与更好的分娩结果显着相关。建议解决健康的社会决定因素，并对高危妇女实施筛查方案。

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

Reproductive Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.00

自引率

5.90%

发文量

220

审稿时长

>12 weeks

期刊介绍： Reproductive Health focuses on all aspects of human reproduction. The journal includes sections dedicated to adolescent health, female fertility and midwifery and all content is open access. Reproductive health is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the capability to reproduce and the freedom to decide if, when, and how often to do so. Men and women should be informed about and have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.