scholarly journals Magnitude and Determinants of Immediate Adverse Neonatal Outcomes Among Babies Born by Cesarean Section in Public Hospitals in Harari Region, Eastern Ethiopia

2021 ◽  
Vol Volume 11 ◽  
pp. 1-12
Author(s):  
Yasir Younis Abdullahi ◽  
Nega Assefa ◽  
Hirbo Shore Roba
Keyword(s):  
Cesarean Section ◽  
Public Hospitals ◽  
Neonatal Outcomes ◽  
Eastern Ethiopia ◽  
Adverse Neonatal Outcomes

scholarly journals Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110183
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neonatal Outcome ◽  
Birth Asphyxia ◽  
Public Hospitals ◽  
Obstructed Labor ◽  
Eastern Ethiopia ◽  
Adverse Neonatal Outcome ◽  
Follow Up Study

The adverse neonatal outcome is defined as the presence of birth asphyxia, respiratory distress, birth trauma, hypothermia, meconium aspiration syndrome, neonatal intensive care admission, and neonatal death. It is a major concern in developing countries, including Ethiopia. This study tried to identify predictors of adverse neonatal outcomes at selected public hospitals in Eastern Ethiopia. A hospital-based prospective follow-up study was conducted in three public hospitals in Eastern Ethiopia from June to October 2020. A total of 2,246 laboring women and neonates born at the hospitals were enrolled in the study. Data were collected through interviews, observation checklists, and clinical chart review. Reports were presented in relative risks with 95% CIs. The overall magnitude of adverse neonatal outcome was 20.97% (95% CI: 19.33- 22.71%). It was 24.3% for babies born through cesarean section (95% CI: 21.3%, 27.5). The presence of meconium in the amniotic fluid increased the risk for neonates delivered via cesarean section (ARR, 1.52 95% CI; 1.04, 2.22). Among neonates born via vaginal delivery, the risk of adverse neonatal outcome was higher among nullipara women (ARR, 1.42 95% CI; 1.02, 1.99) and among women diagnosed with abnormal labor or pregnancy such as APH, pre-eclampsia, obstructed labor, fetal distress, and mal-presentation at admission (ARR, 1.30 95%CI; 1.01, 1.67). The risk of adverse neonatal outcome was higher among babies born through the cesarian section than those born via vaginal delivery. Abnormal labor or pregnancy and being primiparous increased the risk of adverse neonatal outcome in vaginal delivery.

scholarly journals The implications for advanced maternal age on pregnancy complications and adverse neonatal outcomes

2021 ◽  
Vol 29 (3) ◽  
pp. 200-209
Author(s):  
Zeynep Gedik Özköse ◽  
Süleyman Cemil Oğlak
Keyword(s):  
Birth Weight ◽  
Cesarean Section ◽  
Pregnancy Outcomes ◽  
Maternal Age ◽  
Advanced Maternal Age ◽  
Neonatal Outcomes ◽  
Apgar Scores ◽  
Adverse Neonatal Outcomes ◽  
Adverse Pregnancy ◽  
Nicu Admission

Objective This study aimed to determine the effect of advanced maternal age (AMA) on maternal and neonatal outcomes in pregnant women aged ≥35 years compared with patients aged 30–34 years. Also, we aimed to analyze the risk estimates of potential confounders to identify whether these variables contributed to the development of adverse pregnancy outcomes or not. Methods This retrospective cohort study included 2284 pregnant women aged ≥35 years at the time of delivery who was delivered in a tertiary referral hospital from January 1, 2016, to December 31, 2020. We further classified these women into two subgroups: 35–39 years as early AMA (EAMA), and ≥40 years as very AMA (VAMA). Pregnancy complications and adverse neonatal outcomes were recorded. Results Compared to younger women, pregnant AMA women had significantly higher risks of complicated pregnancies, including a higher risk of gestational diabetes mellitus (GDM, p<0.001), polyhydramnios (p<0.001), cesarean section (p<0.001), stillbirths (p<0.001), major fetal abnormality (p<0.001), preterm delivery (p<0.001), lower birth weight (p<0.001), lower 5-minute Apgar scores (p<0.001), lower umbilical artery blood pH values (p<0.001), neonatal intensive care unit (NICU) admission (p<0.001), and length of NICU stay (p<0.001). Conclusion We found a strong and significant association between VAMA and adverse pregnancy outcomes, including an increased risk of GDM, polyhydramnios, cesarean section, and adverse neonatal outcomes, including a higher risk of stillbirths, preterm delivery, lower birth weight, lower 5-minute Apgar scores, and NICU admission.

scholarly journals Predictors of success of trial of labor after cesarean section: A nested case–control study at public hospitals in Eastern Ethiopia

2021 ◽  
Vol 17 ◽  
pp. 174550652110619
Author(s):  
Maleda Tefera ◽  
Nega Assefa ◽  
Kedir Teji Roba ◽  
Letta Gedefa
Keyword(s):  
Cesarean Section ◽  
Cesarean Delivery ◽  
Vaginal Birth ◽  
Public Hospitals ◽  
Vaginal Birth After Cesarean ◽  
Eastern Ethiopia ◽  
Trial Of Labor ◽  
History Of ◽  
Nested Case Control

Background: One of the primary reasons for an increase in cesarean sections is obstetricians’ uncertainty about labor trial safety following a previous cesarean section. The success rate of vaginal birth after cesarean section with a single cesarean scar is greater than 50%. However, to the best of our knowledge, there is a scarcity of information on the determinants of vaginal birth after cesarean delivery in the study area. As a result, the purpose of this study was to identify predictors of successful vaginal birth after cesarean delivery in public hospitals in Eastern Ethiopia. Methods: A nested case–control study design was used within a prospective follow-up study conducted from June to October 2020. A total of 220 women who tried vaginal birth after cesarean delivery was included, 110 cases and 110 controls. Cases were women with one previous cesarean section scar and successfully proceed with vaginal delivery. The controls were those with an earlier cesarean section scar and delivered by emergency cesarean section after trial of labor. A pre-tested structured questionnaire was used to gather the information. Multiple logistic regression is used to identify the determinants for the success of vaginal birth after cesarean section; odds ratio with its 95% CI are used to report the findings. Results: We found that living in rural areas (AOR = 2.28; 95% CI (1.85, 12.41)), having a current antenatal care follow-up (AOR = 3.20; 95% CI (1.15, 8.87)) and partograph monitoring of labor (AOR = 4.26; 95% CI (1.90, 9.57)) had a positive association with successful vaginal birth after cesarean section. In contrast, the presence of meconium-stained amniotic liquor (AOR = 0.10; 95% CI (0.01, 0.75)) and history of stillbirth (AOR = 0.07; 95% CI (0.02, 0.53)) reducing the chance of success of the trial. Conclusion: Past obstetric history, such as stillbirth, history of labor trial after primary cesarean section, and prior vaginal birth, were significant predictors for achieving vaginal birth after cesarean section. Antenatal care visit, and partograph follow-up were the current obstetric characteristics positively associated with the trial of labor.

scholarly journals Main Fetal Predictors of Adverse Neonatal Outcomes in Pregnancies with Gestational Diabetes Mellitus

2020 ◽  
Vol 9 (8) ◽  
pp. 2409
Author(s):  
Maria-Christina Antoniou ◽  
Leah Gilbert ◽  
Justine Gross ◽  
Jean-Benoît Rossel ◽  
Céline Julie Fischer Fumeaux ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Cesarean Section ◽  
Gestational Diabetes Mellitus ◽  
Neonatal Outcomes ◽  
Abdominal Circumference ◽  
Emergency Cesarean Section ◽  
Emergency Cesarean ◽  
Adverse Neonatal Outcomes ◽  
The Impact

The objectives of this study were to (a) assess the utility of fetal anthropometric variables to predict the most relevant adverse neonatal outcomes in a treated population with gestational diabetes mellitus (GDM) beyond the known impact of maternal anthropometric and metabolic parameters and (b) to identify the most important fetal predictors. A total of 189 patients with GDM were included. The fetal predictors included sonographically assessed fetal weight centile (FWC), FWC > 90% and <10%, and fetal abdominal circumference centile (FACC), FACC > 90% and < 10%, at 29 0/7 to 35 6/7 weeks. Neonatal outcomes comprising neonatal weight centile (NWC), large and small for gestational age (LGA, SGA), hypoglycemia, prematurity, hospitalization for neonatal complication, and (emergency) cesarean section were evaluated. Regression analyses were conducted. Fetal variables predicted anthropometric neonatal outcomes, prematurity, cesarean section and emergency cesarean section. These associations were independent of maternal anthropometric and metabolic predictors, with the exception of cesarean section. FWC was the most significant predictor for NWC, LGA and SGA, while FACC was the most significant predictor for prematurity and FACC > 90% for emergency cesarean section. In women with GDM, third-trimester fetal anthropometric parameters have an important role in predicting adverse neonatal outcomes beyond the impact of maternal predictors.

scholarly journals Post cesarean section surgical site infection and associated factors among women who delivered in public hospitals in Harar city, Eastern Ethiopia: A hospital-based analytic cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253194
Author(s):  
Tsegaw Alemye ◽  
Lemessa Oljira ◽  
Gelana Fekadu ◽  
Melkamu Merid Mengesha
Keyword(s):  
Confidence Interval ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Site Infection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Eastern Ethiopia ◽  
Factors Associated

Background Cesarean section (CS) is often complicated by surgical site infection (SSI) that may happen to a woman within 30 days after the operation. This study was conducted to estimate the prevalence of SSI and identify the factors associated with SSI. Methods A hospital-based analytic cross-sectional study was conducted based on the review of medical records of 1069 women who underwent CS in two public hospitals in Harar city. The post-CS SSI is defined when it occurred within 30 days after the CS procedure. Factors associated with SSI were identified using a multivariable binary logistic regression analysis. The analysis outputs are presented using an adjusted odds ratio (aOR) with a corresponding 95% confidence interval (CI). All statistical tests are defined as statistically significant at P-values<0.05. Results The prevalence of SSI was 12.3% (95% confidence interval (CI): 10.4, 14.4). Emergency-CS was conducted for 75.9% (95% CI: 73.2, 78.3) of the women and 13.2% (95% CI: 11.3, 15.4) had at least one co-morbid condition. On presentation, 21.7% (95% CI: 19.3, 24.3) of women had rupture of membrane (ROM). Factors significantly and positively associated with post-CS SSI include general anesthesia (aOR = 2.0, 95%CI: 1.10, 2.90), ROM (aOR = 2.27, 95%CI: 1.02, 3.52), hospital stay for over 7 days after operation (aOR = 3.57, 95%CI: 1.91, 5.21), and blood transfusion (aOR = 4.2, 95%CI: 2.35, 6.08). Conclusion The prevalence of post-CS SSI was relatively high in the study settings. Screening for preoperative anemia and appropriate correction before surgery, selection of the type of anesthesia, close follow-up to avoid unnecessary prolonged hospitalization, and careful assessment of membrane status should be considered to avoid preventable SSI and maternal morbidity.

Cesarean section in term breech presentations: do rates of adverse neonatal outcomes differ by hospital birth volume?

2006 ◽  
Vol 34 (3) ◽  
Author(s):  
Christine Hoehner ◽  
Amy Kelsey ◽  
Nermeen El-Beltagy ◽  
Raul Artal ◽  
Terry Leet
Keyword(s):  
Cesarean Section ◽  
Neonatal Outcomes ◽  
Hospital Birth ◽  
Adverse Neonatal Outcomes

scholarly journals Adverse Neonatal Outcomes and Its Associated Factors Among Mothers with Short and Recommended Interpregnancy Interval, in Awi Zone Public Hospitals, 2020.

2021 ◽  
Author(s):  
Jemberu Chane Fetene ◽  
Amlaku Mulat ◽  
kihinetu Gelaye Wudineh ◽  
Tigist Wubet
Keyword(s):  
Mode Of Delivery ◽  
Adverse Outcomes ◽  
Public Hospitals ◽  
Neonatal Outcomes ◽  
P Value ◽  
Rural Residence ◽  
Interpregnancy Interval ◽  
Cross Sectional ◽  
Adverse Neonatal Outcomes ◽  
Awi Zone

Abstract Background: Short interpregnancy interval is among modifiable risk factors for maternal and neonatal adverse outcomes for planned pregnancies. It is potentially associated with adverse neonatal outcomes which are known to have considerable public health significance. In Ethiopia neonatal mortality was found to be high according to recent mini Ethiopian Demographic Health Survey Report. More importantly information about adverse neonatal outcomes in relation to interpregnancy interval is poorly described yet in Ethiopia. Methods: Institution based comparative cross-sectional study was conducted in Awi zone public hospitals. A total of 482 mothers (241 with short and 241 with recommended IPI) were selected. The data was collected by using systematic random sampling technique through pretested structured questionnaire and entered in to Epi data version 3.1 then exported to Statistical Package of Social Science version 23.0 for analysis. Chi-square and independent t-test were used to compare means. Bivariable and multivariable logistic regression analyses was employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and P value of less than 0.05 considered statistically significant.Result: Among a total of selected mothers with short and recommended Interpregnancy interval (IPI) response rate was 237 (98.3%) and 238 (98.7%) respectively. Proportion of adverse neonatal outcomes were higher among short IPI groups (37.1%). Factors like, rural residence [AOR=6.9, 95%CI (3.32, 14.59)], and Cesarean section delivery [AOR=3.4, 95%CI (1.18, 10.09)] were significantly associated with adverse neonatal outcomes in short IPI groups. Factors like rural residence [AOR=6.1, 95%CI (2.11, 17.7)], unintended pregnancy [AOR=5.3, 95%CI (1.11, 25.00)], rupture of membrane [AOR=6.89, 95%CI (2.54, 18.65)] and induction of labor [AOR=13.4, 95%CI (3.17, 21.77)] were significantly associated in recommended IPI groups.Conclusion: Urban residency and vaginal mode of delivery were significantly associated with less risk of adverse neonatal outcomes in both IPI groups. Whereas, intended pregnancy status, spontaneous labor initiation and absence of ROM before labor were protective for adverse neonatal outcomes in recommended IPI mothers. Provision of proper health service coverage at rural area and minimizing C/S rate to reduce adverse neonatal outcome is recommended.

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