article · PLoS ONE
A retrospective study of deliveries at Debre Berhan Comprehensive Specialized Hospital in Northeast Ethiopia examined the prevalence and drivers of adverse pregnancy outcomes between 2017 and 2018. The overall rate of adverse pregnancy outcomes was 28.3 percent. Common obstetric complications included obstructed labour, retained placenta, and hypertensive disorders, while the primary fetal and neonatal complications were stillbirths, malpresentation, and prematurity. During the study period, twenty-nine maternal deaths occurred, predominantly linked to obstructed labour, haemorrhage, eclampsia, and sepsis. Statistical analysis identified home deliveries and low infant birth weight as significant independent risk factors for adverse outcomes. Promoting institutional deliveries, improving the clinical management and early detection of complications, and supporting adequate maternal nutrition during pregnancy are vital measures to reduce preventable maternal and neonatal morbidity.
Adverse pregnancy outcomes contribute heavily to maternal and neonatal mortality in low- and middle-income countries. Identifying common clinical complications, such as obstructed labour and haemorrhage, alongside key risk factors like home delivery, provides health systems and policymakers with actionable evidence needed to direct maternal healthcare interventions, allocate hospital resources, and encourage safer institutional birth practices.
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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.
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DOI: 10.1371/journal.pone.0271287
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