Determinants of Non-Reassuring Fetal Heart Rate among Deliveries Attended In the Last Two Years in Jimma Zone Public Hospitals, South West, and Ethiopia: Retrospective UN Matched Case-Control Study

Abstract

Background: Non- reassurance fetal heart rate is used to describe an abnormal fetal heart rate that happens when a fetus doesn't get enough oxygen. There is a high rate of neonatal mortality in Ethiopia, and birth asphyxia is a major cause of mortality in the Jimma zone. However, there is little information about the determinants of non-reassurance fetal heart rate in the Zone. Objective: To assess the determinants of non-reassuring fetal heart rate among deliveries attended in Jimma zone public hospitals, South west, Ethiopia, from June 30, 2020, to June 30/2022. Methods: A facility-based unmatched case-control design was conducted in selected Jimma zone public hospitals from August 1 to September 30/2022. Simple random sampling technique was employed to select eligible charts. The data were extracted by using structured checklists. The extracted data were checked, coded, and entered into epi-data version 4.6 and exported to the statistical package for social science version 26 for analysis. Bivariate and multivariable logistic regression was done to identify factors associated with non-reassurance fetal heart rate. Adjusted Odds Ratio at p-value < 0.05 was considered to declare statistically significant variables. The result was presented with tables, figures, and statements. Result: There is a linear slightly decreasing pattern of fetal heart rate among control and case groups rate at base line to 7th 30 minutes. Referral from other health facilities [AOR=.416, 95%CI: (.204, .848)], no antenatal care follow-up [AOR=4.78; 95% CI: (1.03, 22.83)], being primigravida [AOR=2.82, 95%CI: (1.37, 5.78)], prolonged labor [AOR=3.80, 95%CI: (1.28, 11.21)], mothers delivered with cesarean[AOR=8.85, 95%CI: (2.72, 28.84)], and meconium stained amniotic fluid [AOR=5.32, 95%CI: (2.44, 11.6)] were identified as the determinants of non-reassuring fetal heart rate among deliveries attended in the last two years in Jimma zone public hospitals. Conclusion and Recommendation: As the stage of labor progressed the pattern of non reassurance fetal heart rate also increases. No antenatal care follow-up, prolonged labor, Primi-gravida, meconium-stained amniotic fluid, and cesarean section delivery are positively associated and mothers those directly admitted to the hospital were negatively associated among cases with non-reassurance fetal heart rate. Therefore, healthcare providers should follow and provide a continuum of maternity care, especially antenatal care follow-up, and utilize the partograph effectively and efficiently throughout maternity care.