Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Nursing, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
BMC Pregnancy Childbirth. 2022 Sep 8;22(1):693. doi: 10.1186/s12884-022-05021-2.
Direct obstetric causes account for nearly 75% of all maternal deaths. Controversy prevails in the effect of grand multiparity on adverse obstetric outcomes. This study thus aimed to determine and compare the obstetric outcomes in low multiparous (LM) and grand multiparous (GM) women in Public Hospitals of North Ethiopia.
An institution-based comparative cross-sectional study was done among 540 (180 GM and 360 LM) participants from January 1 to March 30, 2021. The data was collected through face-to-face interviews and a review of clinical records and birth registries. Epi-Data version 4.6 was used for data entry and analysis was performed using SPSS version 25.0 statistical software. A p-value of ≤ 0.05 (2-tailed) was used to consider the significance of statistical tests.
The prevalence of adverse obstetric outcomes was 32.6% (95% CI: 28.7-36.5). Antepartum hemorrhage, anemia, and postpartum hemorrhage were higher in grand multiparous women. Whereas, prolonged labor, induction/augmentation, prelabor rupture of membrane, episiotomy, and post-term pregnancy was higher in low multiparous women. Income (AOR (CI) = 3.15 (1.30-7.63), alcohol consumption (AOR (CI) = 3.15 (1.49-6.64), preterm delivery (AOR (CI) = 9.24 (2.28-27.3), cesarean delivery (AOR (CI) = 13.6 (6.18-30.1), and low birth weight (AOR (CI) = 3.46 (1.33-9.03) significant predictors of adverse obstetric outcomes. However, parity did not show a statistically significant difference in obstetric outcomes.
In the study area, obstetric complications were high compared to a systematic review and meta-analysis study done in the country (26.88%). Socio-economic status, alcohol consumption, gestational age at delivery, mode of delivery, and birth weight were significant associates of the obstetric outcome. There was no statistically significant difference in obstetric outcomes between GM and LM women. Socio-economic development, avoiding alcohol consumption, early identification and treatment of complications, and adequate nutrition and weight gain during pregnancy are needed regardless of parity.
直接产科原因几乎占所有孕产妇死亡的 75%。多胎妊娠对不良产科结局的影响存在争议。因此，本研究旨在确定并比较在埃塞俄比亚北部公立医院中低多产妇（LM）和多产妇（GM）的产科结局。
这是一项 2021 年 1 月 1 日至 3 月 30 日在 540 名参与者（180 名 GM 和 360 名 LM）中进行的基于机构的比较性横断面研究。通过面对面访谈和回顾临床记录和分娩登记来收集数据。使用 Epi-Data 版本 4.6 进行数据录入，使用 SPSS 版本 25.0 统计软件进行分析。采用双侧 p 值≤0.05 来考虑统计检验的显著性。
不良产科结局的患病率为 32.6%（95%CI：28.7-36.5）。产前出血、贫血和产后出血在多产妇中更高。而低多产妇中则更高的是产程延长、引产/催产、胎膜早破、会阴切开术和过期妊娠。收入（AOR（CI）=3.15（1.30-7.63））、饮酒（AOR（CI）=3.15（1.49-6.64））、早产（AOR（CI）=9.24（2.28-27.3））、剖宫产（AOR（CI）=13.6（6.18-30.1））和低出生体重（AOR（CI）=3.46（1.33-9.03））是不良产科结局的显著预测因素。然而，多胎次与产科结局之间没有统计学上的显著差异。
在研究区域，与在该国进行的系统评价和荟萃分析研究（26.88%）相比，产科并发症较高。社会经济地位、饮酒、分娩时的胎龄、分娩方式和出生体重是产科结局的重要关联因素。GM 和 LM 妇女之间的产科结局没有统计学上的显著差异。无论多胎次如何，都需要社会经济发展、避免饮酒、早期识别和治疗并发症以及在怀孕期间获得足够的营养和体重增加。
