1
|
Roble AK, Gundappa R, Sheik Abdirahman F, Abdi AM. Determinants of Adverse Birth Outcomes in Public Hospitals of the Somali Region, Eastern Ethiopia: A Multicenter Unmatched Case-Control Study. Clin Med Insights Pediatr 2023; 17:11795565231195253. [PMID: 37641685 PMCID: PMC10460620 DOI: 10.1177/11795565231195253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Background Pregnancy outcomes that differ from normal live births are known as adverse pregnancy outcomes. Adverse pregnancy outcomes also have significant effects on the infant's family and society. There is limited data on adverse outcomes in eastern Ethiopia, particularly in the Somali region. Objectives This study aimed to assess the determinants of adverse birth outcomes in the Somali Region Hospitals. Design A hospital-based unmatched case-control study was conducted to conduct this study. Methods A hospital-based unmatched case-control study was conducted between June and July 2021 in pregnant women who attended public hospitals in the Somali region. A total of 327 (109 cases and 218 controls) participants were included in this study. Women who gave birth with at least 1 adverse birth outcome were considered cases, and those who gave birth with normal birth outcomes were considered controls. Cases were recruited consecutively, and controls were selected using systematic sampling methods. Data was gathered using interviews, record reviews, using the pretested standard tools. The data were entered into EpiData version 3.1 and analyzed with SPSS version 22. Multivariable regression analysis with an adjusted odds ratio and a 95% confidence interval was used to identify the factors associated with adverse birth outcomes. Finally, P-values less than .05 were used to identify significantly associated predictors. Results In the current study, rural residency [AOR = 2.80; 95%CI:(1.61-4.87)] lack of ANC follow-up [AOR = 3.27; 95%CI: (1.77-6.02)], pregnancy-induced hypertension [AOR = 3.28; 95%CI: (1.74-6.17)] being anemic mothers [AOR = 3.51; 95%CI: (2.02-6.07)] and khat chewing [AOR = 4.54; 95%CI: (2.12-9.70)] were identified as determinants of adverse birth outcome. Conclusions In the current study, rural residency, lack of ANC, being anemic in indexed pregnancies, pregnancy-induced hypertension, and khat chewing were determinants of adverse birth outcomes. Therefore, efforts should be made to enhance ANC follow-up, iron and folic acid supplementation, early treatments of pregnancy-induced hypertension, and information on the risk of chewing khat.
Collapse
Affiliation(s)
- Abdurahman Kedir Roble
- School of Nursing and Midwifery, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Raghu Gundappa
- School of Nursing and Midwifery, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Fahima Sheik Abdirahman
- School of Nursing and Midwifery, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Abdurehman Mohamed Abdi
- School of Medicine, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| |
Collapse
|
2
|
Zelka MA, Yalew AW, Debelew GT. The effects of adherence to recommended antenatal services on adverse pregnancy outcomes in Northwest Ethiopia: multilevel and propensity score matching (PSM) modeling. Front Glob Womens Health 2023; 4:1082405. [PMID: 37434914 PMCID: PMC10331614 DOI: 10.3389/fgwh.2023.1082405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/12/2023] [Indexed: 07/13/2023] Open
Abstract
Introduction Adverse pregnancy outcomes are a personal and social crisis caused by easily preventable pregnancy-related problems. Despite that, studies on the effectiveness of adherence to the continuity of antenatal care (ANC) services are scarce. Therefore, this study aims to determine the effectiveness of the continuity of ANC services and the determinants of adverse pregnancy outcomes. Methods A prospective follow-up study design was conducted from March 2020 to January 2021 in Northwest Ethiopia among randomly selected study subjects. Data were collected by trained data collectors using pre-tested structured questionnaires and analyzed using STATA Software version 14. A multilevel regression model was used to identify determinant factors, whereas the propensity score matching (PSM) model was used to look at the effectiveness of adherence to ANC services on adverse pregnancy outcomes. Results Among 2,198 study participants, 26.8% had adverse pregnancy outcomes, with 95% CI: 24.9-28.7 [abortion (6.1%; 95% CI: 5.1-7.1), low birth weight (11.5%; 95% CI: 10.2-12.9), and preterm birth (10.9; 95% CI: 9.6-12.3)]. Determinant factors were iron-folic acid supplementation (AOR = 0.52; 95% CI: 0.41, 0.68), delayed initiation of ANC visits at 4-6 months (AOR = 0.5; 95% CI: 0.32, 0.8), initiation of ANC visits after 6 months (AOR = 0.2; 95% CI: 0.06, 0.66), received four ANC visits (AOR = 0.36; 95% CI: 0.24, 0.49), an average time of rupture of the amniotic membrane of between 1 and 12 h (AOR = 0.66; 95% CI: 0.45, 0.97), and pregnancy-related problems (AOR = 1.89; 95% CI: 1.24, 2.9). As a treatment effect, completion of a continuum of visit-based ANC (ATET; β = -0.1, 95% CI: -0.15, -0.05), and continuum of care via space dimension (ATET; β = -0.11, 95% CI: -0.15, -0.07) were statistically significant on the reduction of adverse pregnancy outcomes. Conclusion In the study area, the rate of adverse pregnancy outcomes was high. Even though adherence to the continuity of ANC services via time and space dimensions is effective in the prevention of adverse pregnancy outcomes, programmatically important factors were also detected. Therefore, key strategies for promoting the uptake of antenatal services and strengthening iron-folic acid supplementation are strongly recommended.
Collapse
Affiliation(s)
- Muluwas Amentie Zelka
- Department of Public Health, College of Health Sciences, Assosa University, Assosa, Ethiopia
- Department of Reproductive Health and Health Services Management, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemayehu Worku Yalew
- Department of Biostatistics and Epidemiology, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gurmesa Tura Debelew
- Department of Population and Family Health, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
3
|
Tadese M, Dagne K, Wubetu AD, Abeway S, Bekele A, Misganaw Kebede W, Baye Mulu G. Assessment of the adverse pregnancy outcomes and its associated factors among deliveries at Debre Berhan Comprehensive Specialized Hospital, Northeast Ethiopia. PLoS One 2022; 17:e0271287. [PMID: 35802663 PMCID: PMC9269379 DOI: 10.1371/journal.pone.0271287] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 06/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adverse pregnancy outcomes are the main causes of maternal and neonatal morbidity and mortality and long-term physical and psychological sequels in low- and middle-income countries, particularly in Africa and Asia. In Ethiopia, maternal mortality remained high despite the country’s maximum effort. This study aimed to assess adverse pregnancy outcomes and associated factors among deliveries at Debre Berhan Comprehensive Specialized Hospital, Northeast Ethiopia. Methods A retrospective cross-sectional study was done among deliveries at Debre Berhan Comprehensive Specialized Hospital from January 1, 2017, to December 31, 2018. The data was collected using a structured and pre-tested questionnaire by reviewing labor and delivery service log books and admission or discharge registration books. The data were entered into a Microsoft Excel spreadsheet and analyzed using SPSS version 25. Logistic regression analysis was computed to identify independent predictors of pregnancy complications. Result In this study, the magnitude of adverse pregnancy outcomes was 28.3%, 95% CI (25.7–30.9). The most frequently recorded obstetric complications were obstructed labor (7.4%), retained placenta (5.3%), and hypertensive disorders of pregnancy (2.4%). Whereas stillbirths (10%), malpresentation (3%), and prematurity (2.3%) frequently occurred fetal/neonatal complications. There were 29 maternal deaths and the possible causes of death were obstructed labor (51.7%), hemorrhage (44.7%), eclampsia (24.1%), and sepsis (6.9%). Home delivery (AOR (CI = 4.12 (2.30–7.15) and low birth weight (AOR (CI = 1.63 (1.36–1.96) were significant associates of adverse pregnancy outcomes. Conclusion The magnitude of adverse pregnancy outcomes was high. Obstructed labor, retained placenta, hypertension in pregnancy, malpresentation, prematurity, and stillbirth are the commonest adverse pregnancy outcomes. Place of delivery and birth weight were independent predictors of adverse pregnancy outcomes. Institutional delivery, early detection and management of complications, and adequate nutrition and weight gain during pregnancy should be encouraged to minimize the risk of adverse pregnancy outcomes.
Collapse
Affiliation(s)
- Mesfin Tadese
- Department of Midwifery, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
- * E-mail:
| | - Kefyalew Dagne
- Department of Psychiatry, College of Health Sciences, Debre Berhan University, Ethiopia
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Ethiopia
| | - Abate Dargie Wubetu
- Department of Psychiatry, College of Health Sciences, Debre Berhan University, Ethiopia
| | - Shiferaw Abeway
- School of Nursing and Midwifery, Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Alemayehu Bekele
- Ethiopian Public Health Association, Research, and Publication Directorate, Addis Ababa, Ethiopia
| | - Worku Misganaw Kebede
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Getaneh Baye Mulu
- Department of Nursing, College of Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| |
Collapse
|
4
|
Belay DM, Bayih WA, Alemu AY, Sinshaw AE, Mekonen DK, Ayele AS, Aytenew TM, Aynew YE, Hailemichael W, Getu S, Kiros M, Andualem H, Birihan BM. Macrosomia and its predictors in pregnant women with diabetes in Ethiopia. Trop Med Int Health 2021; 26:1539-1552. [PMID: 34601758 DOI: 10.1111/tmi.13684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND To estimate the prevalence of macrosomia and contributing factors among pregnant women with diabetes in Ethiopia. METHODS The Cochrane, PubMed, Google Scholar, SCOPUS, Web of Science electronic databases and grey literature found in online university repositories were searched for primary studies reporting the prevalence of macrosomia (birth weight ≥4 kg, irrespective of gestational age) and/or at least one determinant factor using WHO diabetes diagnosis criteria were involved. Variations across the studies were checked using the I2 statistic; funnel plot and Egger's test were used to assess publication bias. A weighted inverse random effect model was used to estimate the overall prevalence of macrosomia. RESULTS The overall prevalence of macrosomic newborns among pregnant women with diabetes [15.1% (95% CI: 9.0%, 21.2%)] was higher than the prevalence among non-diabetic mothers (3.9%). Maternal blood glucose level >100 mg/dl [AOR = 10.5: 95% CI: 5.9, 15.1] and >120 mg/dl [AOR = 8.8: 95% CI: 4.5, 13.0], lack of Antenatal Care (ANC) visit [AOR = 10.8: 95% CI: 6.0, 15.0], previous adverse birth outcomes and advanced maternal age [AOR = 3.5: 95% CI: 1.0, 5.9] were significantly associated with the prevalence of macrosomia at 95% CI. CONCLUSION The pooled prevalence of macrosomia among pregnant women with diabetes was higher than the prevalence among non-diabetic pregnant women (3.9%). Advanced maternal age, previous adverse birth outcomes, lack of ANC and uncontrolled maternal plasma glucose level were independent predictors of macrosomia.
Collapse
Affiliation(s)
- Demeke Mesfin Belay
- Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Maternity and Neonatal Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abebaw Yeshambel Alemu
- Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Aklilu Endalamaw Sinshaw
- Department of Pediatrics and Child Health Nursing, School of Health Sciences, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Demewoz Kefale Mekonen
- Department of Pediatrics and Child Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Tigabu Munye Aytenew
- Department of Adult Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yeshambaw Eshetie Aynew
- Department of Adult Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wasihun Hailemichael
- Molecular Biology and Immunology, Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sisay Getu
- Hematology and Immunohematology, Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mulugeta Kiros
- Medical Microbiology, Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Henok Andualem
- Molecular Biology and Immunology, Department of Medical Laboratory Science, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Binyam Minuye Birihan
- Department of Maternity and Neonatal Health Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| |
Collapse
|