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Determinants of preterm birth among mothers who gave birth at public hospitals in the Amhara region, Ethiopia: A case-control study.

ABSTRACT: BACKGROUND:Preterm birth (PTB) is a public health issue worldwide. In developing nations, like Ethiopia, PTB is under reported and underestimated. However, it is the leading cause of neonatal and under-five mortality in Ethiopia. Besides, limited and non-comparative research studies to date has been conducted in the country to address the prevalence of PTB. Therefore, this study aims to determine predictors of PTB. METHODS:Hospital-based unmatched case control study was employed on a sample of 139 cases and 278 controls from October 2017 to December 2017 in the Amhara region, Ethiopia. The cases and controls were proportionally allocated in each hospital based on the last one-year case flows. As soon as a case was identified, the respective two controls were enrolled until the required sample size was satisfied. The outcome variable was measured by using either last menstrual period (LMP), early ultrasound result, or Ballard maturity examination. Face-to-face interviews were conducted using a standardized, structured, and pre-tested questionnaire to collect data. The collected data was entered into Epi-data and exported into SPSS for analysis. Independent variables with p-values < 0.25 in the bivariate analysis were entered into multivariable logistic regression models with forward logistic regressions method to control the influence of covariates. Ethical clearance was ensured. RESULTS:A total of 134 cases and 268 controls participated with a response rate of 96.4%. After adjusting for covariates, the following variables were associated with PTB: residing in rural areas [AOR = 2.99: 95% CI 1.19, 7.48], low maternal age [AOR = 3.47: 95% CI 1.11, 10.83], being illiterate [AOR = 4.56: 95% CI 1.11,8.62], short birth spacing [AOR = 2.48: 95% CI 1.07, 5.75], no antenatal care visits for this index pregnancy [AOR = 10.78: 95% CI 4.43, 26.25], having a history of previous adverse birth outcomes [AOR = 3.47: 95% CI 1.51, 8.02], and exposure to medical problems during pregnancy [AOR = 13.94: 95% CI 4.39, 24.27]. CONCLUSION:The study revealed maternal sociodemographic factors, short birth space, lack of antenatal care, exposure to previous adverse birth outcomes and facing medical illnesses during pregnancy were the predictors of PTB. Therefore, inclusive preventive and control interventions should be developed at regional, zonal and district levels to reduce the burden of PTB among women resided in rural areas such as integrating antenatal care services into the existing health extension packages. Study results suggest increasing the awareness of PTB, contraceptive utilization and counseling to enhance birth spacing, antenatal care visits, and accessibility to services among women in Ethiopia should be given due attention. Health care providers should focus on mothers with previous adverse birth outcomes and those exposed to medical problems during pregnancy. Additional community based longitudinal studies supplemented with qualitative methods are recommended.

SUBMITTER: Woday A

PROVIDER: S-EPMC6844458 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Determinants of preterm birth among mothers who gave birth at public hospitals in the Amhara region, Ethiopia: A case-control study.

Woday Abay A Muluneh Muluken Dessalegn MD Sherif Samiha S

PloS one 20191111 11

<h4>Background</h4>Preterm birth (PTB) is a public health issue worldwide. In developing nations, like Ethiopia, PTB is under reported and underestimated. However, it is the leading cause of neonatal and under-five mortality in Ethiopia. Besides, limited and non-comparative research studies to date has been conducted in the country to address the prevalence of PTB. Therefore, this study aims to determine predictors of PTB.<h4>Methods</h4>Hospital-based unmatched case control study was employed o ...[more]

PMID: 31710645

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Project description:IntroductionAnemia is a global public health problem that has affected a significant number of pregnant mothers worldwide. The World Health Organization has estimated the prevalence of anemia in pregnant women at 18% and 56% in developed and developing countries, respectively. This study aimed to identify factors associated with severe anemia among laboring women in Mekelle city public hospitals, Tigray, Ethiopia.MethodsThis unmatched case-control study involved 264 (88 = cases and 176 = controls) pregnant women who were recruited when they came for delivery service in Mekelle city public hospitals. The data was collected from July to August, 2016. In this study, a systematic sampling technique was used inselecting controls, but the cases were enrolled until the required sample size was reached. Bivariate and multivariate analyses were conducted to find predictors of severe anemia. Statistically significant predictors of severe anemia were identified at P-value <0.05 and 95% confidence interval.ResultsA total of 264 pregnant women who came for delivery services were enrolled in this study. The major predicting variables for the occurrence of severe anemia among laboring women were residency (AOR = 3.28, 95% CI: 1.26-8.48), number of pregnancies (AOR = 2.46, 95% CI: 1.14-5.29), iron folate supplementation (AOR = 3.29, 95% CI: 1.27-8.49), dietary diversification score (AOR = 3.23, 95% CI: 1.19-8.71) and duration of menstrual cycle (AOR = 2.37, 95% CI: 1.10-5.10). The variable 'blood loss during pregnancy' (AOR = 6.63 95% CI: 2.96-14.86) was identified as a strong predictor of the outcome variable, severe anemia.ConclusionThis study identified determinants of severe anemia among laboring women in Mekelle city public hospitals, Northern Ethiopia. To reduce anemia, strengthening health education provision related to the importance of birth spacing and consuming diversified and iron-enriched food should be considered. Moreover, screening of pregnant women for state of anemia during their visits to health facilities, as well as de-worming for intestinal parasites infection are needed.

Project description:BackgroundWorldwide, preterm birth accounts for 1 million deaths of infants each year and 60% of these deaths occur in developing countries. In addition to the significant health consequences on the infant, preterm birth can lead to economic costs. There was a lack of study in western Ethiopia, and most of those studies conducted in other parts of a country were based on card review with a cross-sectional study design. The risk factors of preterm birth may vary from region to region within the same country due to variation in socioeconomic status and health care service coverage. Therefore, this study aimed to identify determinants of preterm birth in western Ethiopia.MethodsAn institutional-based case-control study was conducted from February 15 to April 15, 2020, in western Ethiopia. The eligible 188 cases and 377 controls were randomly selected for this study. Cases were women who gave birth after 28 weeks and before 37 completed weeks of gestation, and controls were women who gave birth at and after 37 weeks of gestation from the first day of the last normal menstrual period. Data were collected by a structured interviewer-administered questionnaire. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Multivariable logistic regression was used to identify determinants of preterm birth at P-value <0.05.ResultsFrom a total of 565 eligible participants, 516 (172 cases and 344 controls) participated in this study with a response rate of 91.3%. The result of the multivariable analysis shows that mothers who developed pregnancy-induced hypertension (AOR = 3.13, 95% CI; 1.78, 5.50), only one time ANC visits (AOR = 5.99, 95% CI; 2.65, 13.53), experienced premature rupture of membrane (AOR = 3.57, 95% CI; 1.79, 7.13), birth interval less than two years (AOR = 2.96, 95% CI; 1.76, 4.98), developed anemia during the current pregnancy (AOR = 4.20, 95% CI; 2.13, 8.28) and didn't get dietary supplementation during the current pregnancy (AOR = 2.43, 95% CI; 1.51, 3.91) had statistically significant association with experiencing preterm birth.ConclusionAntenatal care service providers should focus on mothers with pregnancy-induced hypertension, premature rupture of membrane, and anemia during pregnancy, and refer to the senior experts for early management to reduce the risk of preterm delivery. Antenatal care services such as counseling the mother on the benefit of dietary supplementation during pregnancy, antenatal care follow up, and lengthening birth interval should be integrated into the existing health extension packages. New and inclusive strategies such as the establishment of comprehensive mobile clinic services should also be designed to reduce the burden of preterm birth among women living in the rural community. Lastly, we recommend future researchers to conduct longitudinal and community-based studies supplemented with qualitative methods.

Project description:BackgroundEven though pregnancy does not affect HIV infection progression, HIV affects the pregnancy outcome. Maternal HIV infection has many untoward effects which include low birth weight which is the major cause of neonatal, infant, and under-five mortality. However, there is controversy and limited information about the effect of HIV status on birth weight around the world including Ethiopia. Therefore, this study aimed to compare the prevalence of LBW and their associated factors among HIV+ and HIV- mothers delivered in Northwest Amhara region referral hospitals.MethodA comparative crossectional study was conducted from September 2016 to September 2019. A simple random sampling technique was used to select 474 participants. Data were collected from the mothers' chart by using a data extraction sheet and then entered into Epi-data and exported into SPSS for analysis. Independent variables with p-values < 0.2 in the bivariable analysis were entered into multivariable logistic regression models with backward logistic regressions method to control confounders and identify the factor.ResultThe overall prevalence of LBW was 13.9% (95% CI:10.8%-17.1%). The prevalence was higher among HIV+ 17.7% (95% CI:14.1%-22.8%) than HIV- mothers 10.1% (95% CI:6.3%-13.8%). CD4 count < 200 cells/mm3 [AOR 3.2, 95%CI (1.05, 9.84)] and between 200-350 cells/mm3 [2.81, 95% CI (1,08, 7.28)], Mothers with MUAC <23 cm [AOR 3.39, 95% CI (1.41, 8.18)] and gestational age <37 weeks [AOR 7.34, 95% CI (3.02,17.80)] were significantly associated with LBW in HIV+ mothers. While, rural residence [AOR 3.93,95% CI (1.356,11.40)], PROM during current pregnancy [AOR 4.96, 95% CI (2.55, 15.83)] and gestational age <37 week [AOR 8.21, 95% CI (2.60, 25.89)] were significantly associated with LBW in HIV negative mothers.ConclusionThe prevalence of LBW was significantly higher among HIV+ mothers as compared to HIV-mothers and this study suggests to emphasize nutritional supplementation of HIV positive mothers, needs to focus on nutritional counseling during ANC/PMTCT follow up and encourage HIV positive mothers to delay their pregnancy until their immune status improve.

Project description:BackgroundPelvic organ prolapse is a common disorder, with up to 40% of women worldwide having some form of anatomical prolapse, and it is a significant public health problem in developing countries including Ethiopia. The prevalence of pelvic organ prolapse in Ethiopia is 13% in Benchi Maji. This study is designed to provide information about the determinants of pelvic organ prolapse among gynecologic patients attending public referral hospitals in the Amhara region, 2020.MethodInstitution-based unmatched case-control study design was conducted from March to June 2020 among randomly selected 348 mothers (116 cases and 232 controls). A convenient sampling technique was used to select cases, and controls were selected by systematic random sampling technique. A pre-tested and structured interviewer-administered questionnaire was used to collect the data. Data were coded and entered into Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Finally, adjusted odds ratio and 95% confidence intervals were used to declare statistical significance.ResultThe result showed that being unable to read and write (illiterate) (adjusted odds ratio = 3.91; 95% confidence interval = 1.06-14.39), age of women >= 40 (adjusted odds ratio = 2.91; 95% confidence interval = 1.255-6.736), giving first birth before age of 20 (adjusted odds ratio = 5.72; 95% confidence interval = 1.73-18.94), carrying heavy objects (adjusted odds ratio = 2.296; 95% confidence interval = 1.102-4.785), parity ⩾ 4 (adjusted odds ratio = 7.02; 95% confidence interval = 1.16-42.45), and family history of pelvic organ prolapse (adjusted odds ratio = 3.09; 95% confidence interval = 1.24-7.71) were significantly associated with pelvic organ prolapse.ConclusionThis study concluded that being unable to read and write, age ⩾ 40, multiparity, family history of pelvic organ prolapse, early childbirth, and carrying heavy objects were the risk factors of pelvic organ prolapse. Providing health education on planning the number of children, and the impact of carrying heavy loads on pelvic organs, preventing early childbirth, and encouraging women to pursue their education at least up to primary school level is recommended.

Project description:BackgroundAdverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. Factors such as the age of the mother, antepartum hemorrhage, history of abortion, gestational age, anemia, and maternal undernutrition have predisposed the mother to adverse birth outcome. For appropriate prevention of the adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. Therefore, this study was aimed to assess the determinants of adverse birth outcomes among women who give birth in public hospitals of western Ethiopia.MethodsAn institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. From mothers who gave birth in public hospitals of Wollega zones, 165 cases and 330 controls were selected. Mothers with adverse birth outcomes were cases and mothers without adverse birth were controls. Data was collected by structured interviewer-administered questionnaires. In addition to the interview, the data collectors abstracted clinical data by reviewing the mother and the babies' medical records. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Finally, multivariable logistic regression was used to identify determinants of adverse birth outcomes at P-value < 0.05.ResultsA total of 495 mothers (165 cases and 330 controls) were included in the study with a mean age of 28.48 + 5.908. Low ANC visit (AOR = 3.92: 95% CI; 1.86, 8.2), premature rupture of membrane (AOR = 2.83: 95% CI; 1.72,4.64), being Anemic (AOR = 2: 95% CI; 1.16,3.44), pregnancy induced-hypertension (AOR = 2.3:95% CI; 1.4,3.85), not getting dietary supplementation (AOR = 2.47:95% CI; 1.6,3.82), and physical abuse (AOR = 2.13: 95% CI; 1.05,4.32) were significantly associated with the development of the adverse birth outcome.ConclusionLow antenatal care visit, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve antenatal care follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.

Project description:BackgroundOne of the key strategies for reducing maternal and perinatal morbidities and mortalities is the provision of skilled intrapartum care. While cesarean section is an important emergency obstetric intervention for saving the lives of mothers and newborns, a study comparing the prevalence of cesarean delivery is not sufficiently available in Ethiopia. This study aimed at assessing the prevalence and associated factors of cesarean delivery among women who gave birth at hospitals in Dessie town, Northeast Ethiopia.MethodsA facility based cross-sectional study was conducted between July and October 2013. A total of 520 women who gave birth in four hospitals (public = 1, private = 3) were interviewed. Face-to-face interviews using a pre-tested and structured questionnaire were conducted for primary data collection. Additionally, patients' charts were reviewed to collect mothers' clinical data. Bivariate and multiple logistic regressions analyses were conducted. Odds ratios and 95% confidence intervals were computed and a P-value of less than 0.05 was taken to declare the level of significance.ResultsA total of 512 mothers were included in the final analysis (response rate = 98.4%), the prevalence of cesarean delivery was found to be 47.6% (95% CI: 44.3, 51.1), While 46 (18.2%) of the procedure conducted in public and 198 (76.1%) were in private hospitals. Partograph monitoring [AOR = 3.84 95%CI: 2.24, 6.59], oxytocin administration [AOR = 4. 80 95%CI: 2.87-8.02], previous cesarean delivery [AOR = 2. 86 95%CI: 1.64-5.01] and place of delivery being a private hospital [AOR = 6. 79 95%CI: 4.18-11.01)] were associated with cesarean delivery.ConclusionThe prevalence of cesarean delivery was found to be high, and was significantly higher in private hospitals than a public facility. There is a need to conduct cesarean delivery audits to appropriately utilize scarce resources. Further an in-depth exploration of the experiences of women with cesarean delivery is necessary.

Dataset Information

Determinants of preterm birth among mothers who gave birth at public hospitals in the Amhara region, Ethiopia: A case-control study.

Publications

Determinants of preterm birth among mothers who gave birth at public hospitals in the Amhara region, Ethiopia: A case-control study.

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