Determinants of neonatal outcome in all modes of delivery in attat hospital, gurage zone, snnp, Ethiopia, retrospective study.

Abstract

Background: The quality of obstetric care is reflected on the level of perinatal and maternal mortality rates of a certain country, which is considered as one of the vital indicators of the health status.The current WHO initiative is to reduce maternal mortality rate by 75% by 2015 and under five mortality rate at least by 75%. There is a gap in knowledge over determinants of mode of delivery and its outcome in the Ethiopian setting. Objective: The objective of this study is to assess determinants of mode of delivery and neonatal outcome in Attat Primary Hospital Method: A retrospective study design review of obstetric and neonatology records were obtained over a period of one year (January 1 to December 2013 G.C). The study was conducted from May1 –June 30, 2014 G.C. All records women admitted to Attat Primary Hospital labor ward with recorded diagnosis of true labor and pregnancy with indication of termination and gave birth were included in this study. The data is collected with pre-prepared structured format by the principal investigator and data collectors. Results were analyzed using Statistical Package for Social Sciences (SPSS) version 20. For all statistical significance tests the cutoff value set or p value is 0.05 and 95% confidence interval. Results: Out of 904 included women, 14 (1.5%) had caesarean section before labor started and 890 (98.5%) were on labor at admission. From women in labor, main modes of delivery were spontaneous vaginal delivery, 452 (50.8%) followed by emergency caesarean section, 224(25.17) and operative vaginal delivery, 185 (20.8%). Of all mothers who gave birth in Attat Primary Hospital 25 (2.8%) of them develop post-partum hemorrhage, hysterectomy was done in 6 (0.7%) mothers, transfusion was done in 14 (1.5%) and 2 (0.2%) maternal deaths were recorded. Regarding fetal outcome, 888(98.2%) live births and 16 (1.8%) of still births were recorded. From live birth babies 71(7.99%) of them had neonatal complications and 27(38%) of them early neonatal deaths. The most common neonatal complications were birth asphyxia, meconium aspiration syndrome and sepsis in 39.4%, 22.5%, and 21.1% and 15.5% for other. Age of the mother, ANC follow up, weight of the neonate and neonatal admission are associated with neonatal death (AOR= 1.157, 95%CI=1.026, 1.304) Conclusion: - Residence and maternal waiting area are significantly associated with mode of delivery whereas, Age of mother, ANC follow up, weight of the neonate and neonatal admission are associated with neonatal outcome. Special attention should be given to mothers in waiting area in deciding mode of delivery and factors related to neonatal death.