Dataset Information

Perinatal outcomes of women with hypertensive disorders of pregnancy in Jimma Medical Center, southwest Ethiopia: Retrospective cohort study.

ABSTRACT:

Background

Hypertensive disorders of pregnancy (HDP) increases adverse perinatal outcomes in women with the disorder. About 16% of all still births and 10% of early neonatal deaths are accounted by HDP. In Ethiopia, HDP complicates about 6% of all pregnancies. Hence, the objective of this study was to determine the risk of adverse perinatal outcomes among women with HDP in Jimma Medical Center, southwest Ethiopia.

Methods

A retrospective cohort study was conducted on a total of 777 women who gave birth from June 2017 to March 2020 at Jimma Medical Center, southwest Ethiopia. Women with HDP and normotensive women who gave birth at or after 28 weeks of gestation were enrolled as exposed and unexposed respectively. Simple random sampling technique was used to select study participants. Data were reviewed using structured data collection performa that was prepared after reviewing relevant literatures. Data were entered to Epi-Data then exported to STATA version 13 for analysis. The adverse perinatal outcomes risk were examined using log binomial and modified Poisson regression model with robust standard errors.

Results

In this study, the overall incidence of adverse perinatal outcome was higher among women with hypertensive disorders of pregnancy (HDP) than normotensive women (64.1% versus 32.8%). After adjusting for confounders, women with HDP were at higher risk of babies with low birth weight (adjusted RR = 2.88 (2.2, 3.75)), preterm birth(aRR = 2.31(1.7, 3.14)), fifth minute low Apgar score (aRR = 2.6(1.53, 4.42)), admission to neonatal intensive care unit (aRR = 1.77(1.32, 2.37), stillbirth (aRR = 2.02(1.11, 3.01)), and perinatal mortality (aRR = 3.88(1.97, 7.66)) than normotensive women.

Conclusion

Women with hypertensive disorder of pregnancy were at higher risk of adverse perinatal outcomes than normotensive women who gave birth at Jimma Medical Center, southwest Ethiopia. Therefore, health care providers should strengthen prevention, early diagnosis and prompt management of HDP in order to reduce adverse perinatal outcomes.

SUBMITTER: Jaleta DD

PROVIDER: S-EPMC8375998 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundThe care of epileptic patients is complicated by the cognitive adverse effect of the drug, disease, pharmacokinetics, and pharmacodynamics properties of antiepileptic drugs which in turn intensify the risk of drug therapy problems among epileptic patients.ObjectiveTo assess drug therapy problems and predicting factors among ambulatory epileptic patients at Jimma University Medical Center, Southwest Ethiopia, from September 2020 to May 2021.MethodologyA hospital-based prospective observational study was conducted. A semi-structured questionnaire was used to collect data from patients as well as from charts. Drug therapy problems were identified using Cipolle's, Morley, and Strand drug therapy problem identification and classification method. Data were entered into Epi data manager version 4.6 and exported to statistical software package for social science version 23.0 for analysis. Multiplestepwise backward logistic regression analysis was carried out to identify predictors of drug therapy problems. The 95% CI was used to show an association between the dependent and independent variables. P-value < 0.05 was considered as statistically significant.ResultsOf the total 320 epileptic patients 224(70.0%) patients had at least one drug therapy problem. A total of 395 drug therapy problems were identified among two hundred twenty-four patients with an average of 1.2 drug therapy problems per patient. The frequently identified drug therapy problems were non-compliance 115(29.11), adverse drug reaction 110(27.84%), and dose too low 103(26%). Getting of a drug by purchasing [AOR = 4.6,95%CI:(2.05-10.7)], poorly involvement of the patients in therapeutic decision making [AOR = 3.02,95%CI:(1.5-6.06)], the number of medications ≥ two [AOR = 5.3,95%CI:(1.2-22.9)] and having had uncontrolled seizure [AOR = 10.9,95%CI:(4.9-24.2)] were independent predictors of drug therapy problems.ConclusionsDrug therapy problems were common among epileptic patients in the study area. Patients who were getting their drugs by purchasing, poorly involved in therapeutic decision making, having had an uncontrolled seizure, and taking two and above drugs were more likely to experience drug therapy problems. Therefore, due attention should be given to patients with the aforementioned problems to decrease the occurrence of drug therapy problems and improve overall outcomes among epileptic patients.

Project description:BackgroundThe characteristics and incidence of adverse drug events (ADEs) among pediatric cancer patients in developing countries have not been well characterized. ADEs & medication errors associated with cancer chemotherapy in children need to be analyzed on their incidence and severity. The purpose of this study was hence, to assess the incidence of adverse drug events and contributing factors among pediatric cancer patients at Jimma university medical center, Jimma, Ethiopia.MethodA prospective observational method was used to study adverse drug events in pediatrics admitted to the pediatric oncology unit of Jimma University medical center between October and December 2020. The ADEs were identified using multifaceted approaches involving daily chart review, interviews of Parents/caregivers (and/or children themselves), attendance at ward rounds, and voluntary staff reports. Both univariate and multivariate logistic regression were used to assess the predictors of the identified ADEs. Those factors that showed association at p-value < 0.25 in the univariate analysis were added to the backward multivariate logistic regression model and the significant association was checked at p-value < 0.05.ResultA total of 73 (46 male and 27 female) patients were included in the study. A total of 466 ADEs were identified with an incidence of 638.36 ADEs per 100 patients, 38.35 ADEs per 100 patient days, and 2.34 ADEs per chemotherapy cycle. The most common ADEs were hematologic toxicities (anemia 55(11.8%), neutropenia 52(11.16%) & thrombocytopenia 31(6.65%)), and gastrointestinal effects (nausea 46(9.87%), vomiting 46(9.87%), anorexia 41(8.8%). Out of 466 ADEs, 150 (32.19%) were classified as common terminology criteria for adverse events (CTCAE) as Grade 1, 199 (42.70%) as Grade 2, 64(13.73%) as Grade 3, 48(10.30%) as grade 4 and 5(1.07%) as Grade 5. Severe acute malnutrition (SAM) is the most common comorbidity present, 20(27.40%) followed by pneumonia, 4(5.50%). Presence of comorbidity (AOR 12.700, CI 1.978-81.549), cancer type (AOR 13.332, CI 3.288-54.059), use of 4 or more chemotherapy drugs (AOR 6.179, CI 1.894-20.165) and length of hospital stay more than 8 days (AOR 5.367, CI 1.167-24.684) were associated with the risk of developing grades 3 and 4 ADEs.ConclusionAdverse drug events were common in the pediatric oncology ward of JUMC. In particular, children with multiple chemotherapy drugs and those with the comorbid condition were at greater risk for adverse drug events.

Project description:IntroductionHypertensive Disorders in Pregnancy (HDP) complicate about 10% of pregnancies. It accounts to 50% of maternal death in sub-Saharan Africa and precedes 15% of perinatal deaths worldwide. In this study, we looked at the perinatal outcomes and factors associated with unfavorable perinatal outcomes among women with hypertensive disorders in pregnancy at Wolaita Sodo teaching and referral hospital, southern Ethiopia.MethodsA hospital based retrospective cross-sectional study design was employed among women hospitalized for hypertensive disorders in pregnancy. Socio-demographic, obstetrics, clinical laboratory, pregnancy complications and outcome were checked from patient records. Descriptive statistics were used to describe parameters collected from patient records. Bivariate and multiple logistic regressions were done to determine factors associated with unfavorable perinatal outcome. A P-value of less than 0.05 and 95% confidence interval not including 1 were considered statically significant.ResultsThere were 168 (2.3%) cases of HDP of the total 7, 347 deliveries during the period of the study from January 2014-December 2016. 72.5% of mothers (72.5%) had vaginal delivery and 26.1% had Caesarean Section. This study revealed a perinatal mortality rate of 111.1 per 1000 live births. On bivariate logistic regression variables such as referral status, diastolic blood pressure, ANC use, types of HDP, fetal weight at birth, maternal complication and maternal outcome were found to be associated with unfavorable perinatal outcomes. On multiple logistic regression fetal weight at birth and maternal outcome were found to be an independent predictors of unfavorable perinatal outcome.ConclusionOur study shows higher perinatal mortality in a tertiary hospital where emergency obstetric and newborn care is set and quality obstetric care is expected. However, tertiary facilities manage difficult cases which can explain the high PMR. But it is high which means there is enough room for improvement. Hence, the referral hospital and neighboring health facilities should give due emphasis for early detection and management of women with HDP.

Project description:ObjectivesThe aim of this study was to determine predictors of adverse perinatal outcome among women who gave birth at Medical Center of Southwest Ethiopia.SettingInstitutional based retrospective cohort study was conducted among women who gave birth at Medical Center of Southwest Ethiopia.ParticipantsMedical record of 777 women was included in the study by using maternity HMIS logbook as entry point. Simple random sampling technique without replacement was employed to select individual medical record using computer generated random numbers.Primary outcome measuredPredictors of adverse perinatal outcome were examined using modified Poisson regression with a robust SE.ResultsMajority, 74.1% of the participants were in the age group of 21-34 years and the median age was 26 (IQR=7) years. More than one-third, 35.9% of the mothers were primigravida and only 21.2% of them had above four antenatal cares (ANC) visit. The overall incidence of adverse perinatal outcome was 31.5% (95% CI: 28.3 to 34.9). Maternal age less than 20 years (adjusted risk ratio, aRR=1.3; 95% CI: 1.01 to 1.5), rural residence (aRR=1.27; 95% CI: 1.04 to 1.59), presence of antepartum haemorrhage in current pregnancy (aRR=1.7; 95% CI: 1.38 to 2.07), maternal anaemia (aRR=1.25; 95% CI: 1.03 to 1.53), lack of ANC visit (aRR=2.29; 95% CI: 1.35 to 3.90), induced labour (aRR=1.77; 95% CI: 1.43 to 2.19) and being positive for venereal disease research laboratory (VDRL) test in current pregnancy (aRR=2.0; 95% CI: 1.16 to 3.38) were found to be significantly associated with adverse perinatal outcome.ConclusionThe incidence of adverse perinatal outcome in the study area is high and maternal age less than 20, rural residency, maternal anaemia, antepartum haemorrhage in the current pregnancy, inadequate ANC visit, induction of labour and being positive for VDRL test were found to predict occurrence of adverse perinatal outcome. Majority of these problems can be managed by providing quality antenatal, intrapartum and post-natal care.

Project description:Background:Worldwide, 10-20% of women experience depression during pregnancy. In sub-Saharan countries, depression during pregnancy is estimated to be 15-57%. Even though there is a high burden of depression during pregnancy, little attention has been given to identify sociodemographic and obstetric determinants in diverse populations like Ethiopia. Objective:To identify sociodemographic and obstetric determinants of antenatal depression among women attending an antenatal clinic at Jimma Medical Center, southwest Ethiopia. Patients and Methods:A case-control study was conducted among 246 pregnant mothers (82 cases and 164 controls) attending an antenatal clinic in Jimma Medical Center from June 1 to August 30, 2019. Antenatal depression was assessed using the Beck Depression Inventory-II. Epidata 3.1 and SPSS v24 were used for data entry and analysis, respectively. Adjusted odds ratios (AOR) and 95%CIs were estimated using logistic regression models. Statistical significance was set at P<0.05. Results:Married mothers were 67% (AOR=0.33, 95%CI: 0.15-0.75), housewives were 97% (AOR=0.03, 95%CI: 0.01-0.14), private workers were 87% (AOR=0.13, 95%CI: 0.04-0.44), and government employees were 84% (AOR=0.16, 95%CI: 0.05-0.46), less likely to develop antenatal depression. Multigravida were 88% (AOR=0.12, 95%CI: 0.04-0.37) less likely to develop antenatal depression. Third trimester pregnancy was four times (AOR=4.04, 95%CI: 1.51-10.81) more likely to have depression. Mothers who having wanted pregnancy were 83% (AOR=0.17, 95%CI: 0.04-0.81) less likely to develop antenatal depression compared with mothers having unwanted pregnancy. Conclusion and Recommendation:Being married, multigravida, having wanted pregnancy and occupation status (housewives, private workers and government employees) can protect mothers from developing antenatal depression. Mothers with third trimester pregnancy were four times more likely to have depression. Designing a screening and intervention strategy for antenatal depression must consider the aforementioned protective and risk factors.

Project description:Background:In health care, patient satisfaction is an attitudinal response and a pillar for quality assurance, but there is reluctance to measure it among mentally ill patients. Satisfied patients become more compliant. However, no study was done in this study area before. Therefore, this study was conducted to determine the magnitude of perceived patient satisfaction and associated factor at Jimma University Medical Center, outpatient psychiatry clinic. Methods:Cross-sectional study design was conducted, and systematic random sampling technique was used to get study participants. The 24-item Mental Health Service Satisfaction Scale (a validated tool in Ethiopia) was used to assess patient satisfaction. Data was entered using Epi-data 3.1 and exported to the Statistical Package for the Social Sciences 22.0 for analysis. Linear regression analysis (P < 0.05) was used to identify the association between the outcome and independent variable. Result:414 respondents participated in the study with response rate of 98%. The overall percentage of patient satisfaction was 50.3% (95% CI 48.4%-51.2%). Being male (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (? = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (Conclusion and Recommendation. This study found that half of the study participants are satisfied with the service. Distance from the hospital, current substance use, waiting time, and having good social support were identified as modifiable factors that can be improved through working with stakeholders to increase patient satisfaction.

Project description:BACKGROUND:Novel-coronavirus disease-2019 (COVID-19) is currently a pandemic and public health emergency of international concern, as avowed by the World Health Organization (WHO). Ethiopia has become one of the affected countries as of March 15, 2020. OBJECTIVE:This study aimed to assess the knowledge, perceptions, and practices among the Jimma University medical center (JUMC) visitors in Jimma town. METHODS:A cross-sectional study was conducted on 247 sampled visitors, from 20-24 March 2020. Consecutive sampling was used to recruit the participants. The study tools were adapted from WHO resources. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 20.0. Descriptive statistics were used to describe the status of knowledge, perception, and practices. Logistic regression was executed to assess the predictors of dominant preventive practices. RESULTS:Of the 247 respondents, 205 (83.0%) knew the main clinical symptoms of COVID-19. 72.0% knew that older people who have chronic illnesses are at high risk of developing a severe form of COVID-19. About 95.1% knew that the COVID-19 virus spreads via respiratory droplets of infected people, while 77 (31.2%) of the respondents knew about the possibility of asymptomatic transmission. Only 15 (6.1%) knew that children and young adults had to involve preventive measures. Overall, 41.3% of the visitors had high knowledge. The majority, 170(68.8%), felt self-efficacious to controlling COVID-19. 207(83.3%) believed that COVID-19 is a stigmatized disease. Frequent hand washing (77.3%) and avoidance of shaking hands (53.8%) were the dominant practices. Knowledge status and self-efficacy (positively), older age, and unemployment (negatively) predicted hand washing and avoidance of handshaking. CONCLUSIONS:The status of knowledge and desirable practices were not sufficient enough to combat this rapidly spreading virus. COVID-19 risk communication and public education efforts should focus on building an appropriate level of knowledge while enhancing the adoption of recommended self-care practices with special emphasis on high-risk audience segments.