Gudeta Habtamu Tadesse, Nagari Shalama Lekasa, Jabana Dessalegn Emana, Legese Mustefa Aflegn, Biyena Demekisa Wondimu, Kassie Fantahun Cheklie
Department of Public Health, College of Health Science, Assosa University, Benishangul-Gumuz region, Assosa Town, Ethiopia.
Department of Nursing, College of Health Science, Assosa University, Benishangul-Gumuz region, Assosa Town, Ethiopia.
BMC Pregnancy Childbirth. 2025 Jan 30;25(1):87. doi: 10.1186/s12884-025-07191-1.
Adverse birth outcomes are a significant public health problem worldwide, particularly in low- and middle-income countries. Adverse birth outcomes have significant immediate and long-term health consequences for infants and their families. Understanding the determinants of adverse birth outcomes is crucial to effective interventions. For this purpose, this study aimed to assess the incidence and predictors of adverse birth outcomes among women who gave birth at Assosa General Hospital.
An institution-based retrospective cohort study design was used to select 715 mothers who gave birth at the hospital. The study participants were selected by using simple random sampling. Bivariate and multivariable logistic regression analyses were executed to identify predictor variables of adverse birth outcomes. Finally, a multivariable logistic regression model at P-value < 0.05 and adjusted relative risk (ARR) with 95% CI were used to declare predictor variables that were statistically significant with adverse birth outcomes.
The majority, 465 (65.0%), of mothers were in the 20-34 year age group. The mean age of mothers was 26.9 (± 5.5 SD) years. This study revealed that the incidence of adverse perinatal outcomes was 29.7% (95% CI: 26.3-33.1). The common adverse birth outcomes identified in this study were low birth outcomes (159, 22.2%), preterm birth outcomes (14.8%), birth defects (5.7%), and stillbirth outcomes (3.9%). This study revealed that variables such as antenatal care, hemoglobin, mid-upper arm circumference, malaria status, and hypertension were statistically significant predictors of adverse birth outcomes. Statistically significant independent predictors of adverse birth outcomes were included fewer than 4 prenatal care visits (aRR = 3.53, 95% CI: 1.58, 5.37), malaria cases (aRR = 10.74, 95% CI: 6.56, 17.57), pregnancies with hypertensive disorders (aRR = 3.41, 95% CI: 2.17, 6.47), hemoglobin < 11 g/dl (aRR = 3.68, 95% CI: 2.42, 5.74), and a MUAC < 23 (aRR = 5.90, 95% CI: 3.98, 10.80).
There was a high incidence of adverse birth outcomes in the study area. This study revealed that inadequate antenatal care follow-up, malaria, hypertension, hemoglobin < 11 g/dl, and a mid-upper arm circumference < 23 cm were predictors of adverse birth outcomes. Governments and health authorities should prioritize policies and programs that are aimed at reducing adverse birth outcomes. Improving maternal health services, nutrition education, early diagnosis, and treatment can help to manage most of these predictors.
不良分娩结局是全球重大的公共卫生问题，在低收入和中等收入国家尤为突出。不良分娩结局对婴儿及其家庭有着重大的近期和长期健康影响。了解不良分娩结局的决定因素对于有效干预至关重要。为此，本研究旨在评估在阿索萨综合医院分娩的妇女中不良分娩结局的发生率及预测因素。
采用基于机构的回顾性队列研究设计，选取在该医院分娩的715名母亲。研究参与者通过简单随机抽样选取。进行双变量和多变量逻辑回归分析以确定不良分娩结局的预测变量。最后，使用P值<0.05且调整相对风险（ARR）及95%置信区间的多变量逻辑回归模型来宣布与不良分娩结局具有统计学显著意义的预测变量。
大多数母亲（465名，65.0%）年龄在20 - 34岁组。母亲的平均年龄为26.9（±5.5标准差）岁。本研究显示，不良围产期结局的发生率为29.7%（95%置信区间：26.3 - 33.1）。本研究中确定的常见不良分娩结局为低出生体重（159例，22.2%）、早产（14.8%）、出生缺陷（5.7%）和死产（3.9%）。本研究表明，诸如产前检查、血红蛋白、上臂中段周长、疟疾状况和高血压等变量是不良分娩结局的统计学显著预测因素。不良分娩结局的统计学显著独立预测因素包括产前检查次数少于4次（调整相对风险 = 3.53，95%置信区间：1.58，5.37）、疟疾病例（调整相对风险 = 10.74，95%置信区间：6.56，17.57）、患有高血压疾病的妊娠（调整相对风险 = 3.41，95%置信区间：2.17，6.47）、血红蛋白<11 g/dl（调整相对风险 = 3.68，95%置信区间：2.42，5.74）以及上臂中段周长<23（调整相对风险 = 5.90，95%置信区间：3.98，10.80）。
研究区域内不良分娩结局的发生率较高。本研究表明，产前检查随访不足、疟疾、高血压、血红蛋白<11 g/dl以及上臂中段周长<23 cm是不良分娩结局的预测因素。政府和卫生当局应优先制定旨在减少不良分娩结局的政策和项目。改善孕产妇保健服务、营养教育、早期诊断和治疗有助于应对这些预测因素中的大多数。
