MAGNITUDE OF ADVERSE BIRTH OUTCOMES AND ASSOCIATED FACTORS AMONG MOTHERS DELIVERING IN PUBLIC HEALTH INSTITUTIONS OF KEMBATA TEMBARO ZONE, SOUTHERN ETHIOPIA

Abstract

Background: Though there has been improvements of birth outcomes in the past decades it is not expected. Adverse birth outcomes are big challenges of neonatal health in developing countries including Ethiopia. Still birth, preterm birth, low birth weight and birth asphyxia are the major contributors of adverse birth outcome. There is limited data on adverse birth outcomes and intrapartum conditions and care in southern Ethiopia. This study tried to fill this gap by considering important factors like intrapartum conditions, partograph related factors, and maternal complications and interventions. Objectives: To assess the magnitude of adverse birth outcomes and associated factors among mothers delivering in public health institutions of Kembata Tembaro Zone, Southern Ethiopia, Jan 31 – Feb 15/2017. Methods: An institutional based cross-sectional study was conducted using record review data of 770 maternal delivery records from three randomly selected health facilities which were stratified to general and primary hospital and health center. All women who gave birth at public health institutions of Kembata Tembaro Zone from September, 01/2016 to December, 31/2016 and those fulfill the inclusion criteria were included. The actual data collection was made after pretest done on 38 maternal delivery records. Frequencies, proportion, and summary statistics were used to describe relevant variables. Bivariate analysis was carried out to identify factors that are associated with birth outcome. Multiple logistic regression analysis was performed for those factors appeared with p-value <0.25 in bivariate analysis to identify independent factors associated by controlling for possible confounders. Results: The magnitude of adverse birth outcome was 13.9%. Lack of ANC follow-up [AOR = 11.133 (CI 3.2-30)], mal-presentation [AOR = 6.08 (CI 1.8-19.9)], ruptured membrane at admission [AOR = 2.5 (CI 1.42-4.49)], substandard monitoring of fetal heart beat [AOR = 2.7 (CI 1.47-5.3)], urine test not done for protein and ketone [AOR = 2.13 (CI 1.09-4.16)], antepartum hemorrhage [AOR = 8.086 (CI 2.624-24.917)], pregnancy induced hypertension [AOR = 8.427 (CI 2.488-28.542)] and premature rupture of membrane [AOR = 6.191 (CI 1.746-21.946)] were factors independently associated with adverse birth outcomes. Conclusion: The magnitude of adverse birth outcomes was 13.9%. Many of the factors that are attributed to adverse birth outcomes are modifiable. This result could call for increasing ANC coverage; improvement of intrapartum care; prevention, early diagnosis and management of maternal complications.