ADVERSE BIRTH OUTCOME AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN MANAGED BY MAGNESIUM SULPHATE IN HIWOT FANA COMPREHENSIVE SPECIALIZED UNIVERSITY HOSPITAL, HARARI REGIONAL STATE, EASTERN ETHIOPIA

Abstract

Background: Magnesium sulphate has a long history of use in obstetrics. It is supported as the first line treatment for women with eclampsia and is the drug of choice for women with severe pre-eclampsia. In Ethiopia, magnesium sulphate is introduced as anticonvulsant for treatment of severe pre-eclampsia and eclampsia and has been introduced into the National Drug List of Ethiopia and is being used for prevention and treatment of severe pre-eclampsia and eclamptic seizures since January 2011 in public hospitals. However, there are no enough studies done to assess birth outcome and associated factors among women managed by MgSO4 in public hospitals in Ethiopia in general and in Hiwot Fana Specialized University Hospital in particular. Objective: The aim of this study is to assess adverse birth outcome and associated factors among pregnant women managed by magnesium sulphate in Hiwot Fana Specialized University Hospital, Harari Regional state, Eastern Ethiopia, from January 1, 2019 – June 31, 2021. Methods: Institution based cross-sectional study was conducted in Hiwot Fana Comprehensive Specialized University Hospital. A total of 868 documents of mothers were reviewed. A pretested standardized checklist was used for data extraction. Data was entered to EpiData version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics, bivariable and multivariable logistic regression analysis was performed. All covariates with p value ≤0.25 in bivariable logistic regression were entered into multivariable logistic regression analysis to control the confounding. Significance of statistical association was tested by using 95% confidence interval and p value (<0.05). Result: Among 868 pregnant mothers who were managed by MgSO4, 203 (23.4%) still birth &665(76.6%) alive. Rural residence (AOR= 2.77, 95% CI: 1.54, 5.01), primi para(AOR= 3.01, 95% CI: 1.46 , 6.21), being preterm at delivery (AOR= 1.61, 95% CI: 1.16, 2.238), MgSO4 toxicity(AOR= 21.33, 95% CI: 2.53, 8.21) and mode of onset of labour spontaneous (AOR= 1.52, 95% CI: 1.06 , 2.20) are significantly associated with still birth. Conclusions: In this study, one out of three pregnant mothers managed by MgSO4 had still births. Residence, parity, GA at delivery, MgSO4 toxicity & mode of onset of labour are significantly associated with birth outcome.