Bolka Amelo, Weldekidan Zerihun
School of Public Health, Yirgalem Hospital Medical College, Yirgalem, Ethiopia.
PLOS Glob Public Health. 2025 Jun 5;5(6):e0004582. doi: 10.1371/journal.pgph.0004582. eCollection 2025.
Despite rising cesarean section (CS) rates in Ethiopia, evidence on determinants of postoperative length of hospital stay (LoS) remains scarce, particularly for rural general hospitals handling most deliveries. This study was aimed at assessing the length of hospital stay and its associated factors among women who undergo cesarean section in general hospitals of the Sidama region. An institution-based cross-sectional study was conducted among 505 post-CS mothers from 1 January to 20 February 2024. A multistage sampling method was followed to select the study respondents. Data was collected using a structured and pretested, interviewer-administered questionnaire. Data was collected using the Kobo Toolbox system and exported to Stata version 14.0 for management and analysis. Factors associated with the length of hospital stay were determined using a Poisson regression model. The factors associated with the outcome variable were identified using the adjusted risk ratio (ARR). Statistical significance was set at a p-value of less than 0.05. The median LoS post-CS was 4 days (interquartile range: 3-4). Significant predictors of prolonged LoS included maternal age (ARR = 1.014, 95% CI: 1.004-1.024), neonatal intensive care unit (NICU) admission (ARR = 1.31, 95% CI: 1.16-1.46), surgical site infection (ARR = 2.39, 95% CI: 1.88-3.04), and low postoperative hemoglobin (ARR = 0.94, 95% CI: 0.92-0.97). The median hospital stay after cesarean delivery in general hospitals of Sidama region was 4 days. Prolonged stays were associated with maternal age, NICU admission, surgical site infection, and low post-op hemoglobin. Targeting high-risk mothers with enhanced monitoring and wound care-alongside NICU-maternity service integration and safety-conscious discharge protocols-is recommended to accelerate recovery.
尽管埃塞俄比亚的剖宫产率不断上升,但关于术后住院时间(LoS)决定因素的证据仍然很少,尤其是对于处理大多数分娩的农村综合医院而言。本研究旨在评估锡达马地区综合医院剖宫产妇女的住院时间及其相关因素。2024年1月1日至2月20日,对505名剖宫产术后母亲进行了一项基于机构的横断面研究。采用多阶段抽样方法选择研究对象。通过结构化且经过预测试的、由访谈员管理的问卷收集数据。数据使用Kobo Toolbox系统收集,并导出到Stata 14.0版本进行管理和分析。使用泊松回归模型确定与住院时间相关的因素。使用调整风险比(ARR)确定与结果变量相关的因素。统计学显著性设定为p值小于0.05。剖宫产术后LoS的中位数为4天(四分位间距:3 - 4天)。LoS延长的显著预测因素包括产妇年龄(ARR = 1.014,95%CI:1.004 - 1.024)、新生儿重症监护病房(NICU)入院(ARR = 1.31,95%CI:1.16 - 1.46)、手术部位感染(ARR = 2.39,95%CI:1.88 - 3.04)和术后血红蛋白水平低(ARR = 0.94,95%CI:0.92 - 0.97)。锡达马地区综合医院剖宫产术后的中位住院时间为4天。住院时间延长与产妇年龄、NICU入院、手术部位感染和术后血红蛋白水平低有关。建议针对高危母亲加强监测和伤口护理,同时整合NICU与产科服务,并制定注重安全的出院方案,以加速康复。