Authors :
Mary Kuir Kuol; Paul Kosiyo; Peter Omemo; Edina Nyangechi
Volume/Issue :
Volume 9 - 2024, Issue 7 - July
Google Scholar :
https://tinyurl.com/y4sp2y9a
Scribd :
https://tinyurl.com/ycx3p3cp
DOI :
https://doi.org/10.38124/ijisrt/IJISRT24JUL999
Abstract :
Adverse pregnancy outcome (APO) refers to
gestation results other than vaginal birth, which include
premature birth, miscarriage and low birth weight which
are main causes of maternal and neonatal illness and
death. In Kenya, the maternal mortality ratio stands at
355 deaths per 100,000 live births. In Kisumu County
maternal mortality rate stands at 495 per 100,000 live
births per year and Nyando Sub-County has the second-
worst record of adverse pregnancy outcomes. Therefore,
the current the current study assessed the determinants
of adverse pregnancy outcomes among women attending
4 selected public health facilities in Nyando Sub-County.
In this multicenter hospital-based cross-sectional study,
n=301 women who delivered at the 4 randomly selected
hospitals Nyando Sub-County hospital and visited the
ANC department at least twice were systematically
randomly recruited from November 2022 to September
2023. Data was collected using pre-tested and structured
questionnaire which consisted of sections of demographic
and obstetric characteristics. Presence of at least one
maternal complication was used to determine the
presence of APO. SPSS version 27 was used for data
analysis. Chi-square ( 2) was used to compare
proportions based on pregnancy outcomes as normal and
adverse. Association between socioeconomic status and
APO, obstetric factors and APO as well as ANC visits and
APO were determine using Binary logistic regression. Of
the 301 participants, 96 (31.9%) had normal pregnancy
outcome (NPO) while 205 (68.1%) had APO. Woman’s
age, parity, marital status, family income and education
were associated with APO p=0.001, p=0.001, p=0.001,
p=0.001 and p=0.04 respectively. With regard to obstetric
factors, women of between 16-35 years were less likely to
develop APO [OR=0.410, 95% CI=0.260-0.670, p=0.001].
In terms of gestation period with 37 weeks as the
reference group, women with 28-37 weeks of gestation are
less likely to develop APO [OR=0.114, 95% CI=0.132-
0.497, p=0.001].
The study did not find any association with the
number of ANC visits [OR=0.39 95% CI=0.36-1.26,
p=0.314] however, women visiting ANC in the second
trimester less likely to develop APO [OR=0.221, 95%
CI=0.142-0.927, p=0.001]. Therefore, both
sociodemographic and obstetric factor affect pregnancy
outcome and early ANC visit is associated with better or
normal pregnancy outcome.
Keywords :
Pregnancy Outcomes, Women, Antenatal Clinic.
References :
- Muluneh AG, Asratie MH, Gebremariam T, Adu A, Enyew MM, Cherkos EA, et al. Lifetime adverse pregnancy outcomes and associated factors among antenatal care booked women in Central Gondar zone and Gondar city administration, Northwest Ethiopia. Front Public Health. 2022;10:966055.
- Voit FAC, Kajantie E, Lemola S, Räikkönen K, Wolke D, Schnitzlein DD. Maternal mental health and adverse birth outcomes. PLoS One. 2022;17(8):e0272210.
- Roble AK, Gundappa R, Sheik Abdirahman F, Abdi AM. Determinants of Adverse Birth Outcomes in Public Hospitals of the Somali Region, Eastern Ethiopia: A Multicenter Unmatched Case-Control Study. Clin Med Insights Pediatr. 2023;17:11795565231195253.
- Tadese M, Dagne K, Wubetu AD, Abeway S, Bekele A, Misganaw Kebede W, et al. Assessment of the adverse pregnancy outcomes and its associated factors among deliveries at Debre Berhan Comprehensive Specialized Hospital, Northeast Ethiopia. PLoS One. 2022;17(7):e0271287.
- Farladansky-Gershnabel S, Levy G, Neiger R. Obstetric Complications and Pregnancy Outcome Among Grand Multiparous Women. J Reprod Med. 2016;61(9-10):452-6.
- Tamirat KS, Sisay MM, Tesema GA, Tessema ZT. Determinants of adverse birth outcome in Sub-Saharan Africa: analysis of recent demographic and health surveys. BMC Public Health. 2021;21(1):1092.
- Abadiga M, Mosisa G, Tsegaye R, Oluma A, Abdisa E, Bekele T. Determinants of adverse birth outcomes among women delivered in public hospitals of Ethiopia, 2020. Archives of Public Health. 2022;80(1):12.
- Jukic AM, Baird DD, Weinberg CR, McConnaughey DR, Wilcox AJ. Length of human pregnancy and contributors to its natural variation. Hum Reprod. 2013;28(10):2848-55.
- WHO. Maternal Mortality Rate Fact sheet. 2024.
- KDHS. Kenya Demographic Health Survey KNBS. 2022.
- KNBS. Kenya Population and Housing Census (10 Per Cent sample, every 10th household), Population and Housing Census. 2019.
- Lurie S, Zalmanovitch A, Golan A, Sadan O. The effect of marital status on pregnancy outcome in Israel: a retrospective case-control study. J Obstet Gynaecol Res. 2010;36(6):1161-4.
- WHO. The Determinants of Health Available from https://WWW.whoint/hia/evidence/doh/en/. 2019.
- Singh GK, Daus GP, Allender M, Ramey CT, Martin EK, Perry C, et al. Social Determinants of Health in the United States: Addressing Major Health Inequality Trends for the Nation, 1935-2016. Int J MCH AIDS. 2017;6(2):139-64.
- Dadras O, Dadras F, Taghizade Z, Seyedalinaghi S, Ono-Kihara M, Kihara M, et al. Barriers and associated factors for adequate antenatal care among Afghan women in Iran; findings from a community-based survey. BMC Pregnancy Childbirth. 2020;20(1):427.
- Akowuah JA, Agyei-Baffour P, Awunyo-Vitor D. Determinants of Antenatal Healthcare Utilisation by Pregnant Women in Third Trimester in Peri-Urban Ghana. J Trop Med. 2018;2018:1673517.
- Asefa U, Ayele WM. Adverse Obstetrical and Perinatal Outcomes Among Advanced Age Pregnant Mothers in Northeast Ethiopia: A Comparative Cross-Sectional Study. Int J Womens Health. 2020;12:1161-9.
- Dadras O, Nakayama T, Kihara M, Ono-Kihara M, Seyedalinaghi S, Dadras F. The prevalence and associated factors of adverse pregnancy outcomes among Afghan women in Iran; Findings from community-based survey. PLoS One. 2021;16(1):e0245007.
- UN. Kenya country Factheet on Female reproductive age. 2019.
- Heazell AEP, Newman L, Lean SC, Jones RL. Pregnancy outcome in mothers over the age of 35. Curr Opin Obstet Gynecol. 2018;30(6):337-43.
- Attali E, Yogev Y. The impact of advanced maternal age on pregnancy outcome. Best Pract Res Clin Obstet Gynaecol. 2021;70:2-9.
- Asundep NN, Jolly PE, Carson A, Turpin CA, Zhang K, Tameru B. Antenatal care attendance, a surrogate for pregnancy outcome? The case of Kumasi, Ghana. Matern Child Health J. 2014;18(5):1085-94.
- Aliyu MH, Jolly PE, Ehiri JE, Salihu HM. High parity and adverse birth outcomes: exploring the maze. Birth. 2005;32(1):45-59.
- Patel KK, Saroj RK, Kumar M. Prevalence and Determinants of Adverse Pregnancy Outcomes among Women in India: A Secondary Data Analysis. Indian J Community Med. 2021;46(3):434-7.
- Dalfrà MG, Del Vescovo GG, Burlina S, Baldan I, Pastrolin S, Lapolla A. Celiac Disease and Pregnancy Outcomes in Patients with Gestational Diabetes Mellitus. Int J Endocrinol. 2020;2020:5295290.
Adverse pregnancy outcome (APO) refers to
gestation results other than vaginal birth, which include
premature birth, miscarriage and low birth weight which
are main causes of maternal and neonatal illness and
death. In Kenya, the maternal mortality ratio stands at
355 deaths per 100,000 live births. In Kisumu County
maternal mortality rate stands at 495 per 100,000 live
births per year and Nyando Sub-County has the second-
worst record of adverse pregnancy outcomes. Therefore,
the current the current study assessed the determinants
of adverse pregnancy outcomes among women attending
4 selected public health facilities in Nyando Sub-County.
In this multicenter hospital-based cross-sectional study,
n=301 women who delivered at the 4 randomly selected
hospitals Nyando Sub-County hospital and visited the
ANC department at least twice were systematically
randomly recruited from November 2022 to September
2023. Data was collected using pre-tested and structured
questionnaire which consisted of sections of demographic
and obstetric characteristics. Presence of at least one
maternal complication was used to determine the
presence of APO. SPSS version 27 was used for data
analysis. Chi-square ( 2) was used to compare
proportions based on pregnancy outcomes as normal and
adverse. Association between socioeconomic status and
APO, obstetric factors and APO as well as ANC visits and
APO were determine using Binary logistic regression. Of
the 301 participants, 96 (31.9%) had normal pregnancy
outcome (NPO) while 205 (68.1%) had APO. Woman’s
age, parity, marital status, family income and education
were associated with APO p=0.001, p=0.001, p=0.001,
p=0.001 and p=0.04 respectively. With regard to obstetric
factors, women of between 16-35 years were less likely to
develop APO [OR=0.410, 95% CI=0.260-0.670, p=0.001].
In terms of gestation period with 37 weeks as the
reference group, women with 28-37 weeks of gestation are
less likely to develop APO [OR=0.114, 95% CI=0.132-
0.497, p=0.001].
The study did not find any association with the
number of ANC visits [OR=0.39 95% CI=0.36-1.26,
p=0.314] however, women visiting ANC in the second
trimester less likely to develop APO [OR=0.221, 95%
CI=0.142-0.927, p=0.001]. Therefore, both
sociodemographic and obstetric factor affect pregnancy
outcome and early ANC visit is associated with better or
normal pregnancy outcome.
Keywords :
Pregnancy Outcomes, Women, Antenatal Clinic.