Birth outcomes among laboring mothers in selected health facilities of North Wollo Zone, Northeast Ethiopia: A facility based cross-sectional study

Asmamaw Eshete, Dereje Birhanu, Belaynew Wassie

Amhara Health Bureau, Bahir Dar, Ethiopia.
Department of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
Research & Training Institute, John Snow Inc. (JSI), Bahir Dar, Ethiopia.

DOI: 10.4236/health.2013.57154                

Abstract

Background: Poor birth outcomes are common health problems everywhere in the world. Hence institutional delivery in Ethiopia is very low, improving birth outcomes through recent evidence remained critical. The objective of the study was to determine the prevalence of poor birth outcomes and associated factors among women who delivered in selected health facilities of North Wollo Zone. Methods: A facility based cross-sectional survey was conducted on 295 laboring mothers from May to June 2009. Interviewer administered questionnaire was used to collect the data. Patient’s chart was reviewed to retrieve medical information. Anthropometry of the neonate was taken by standard measurement tools. Data were analyzed using statistical package for social sciences (SPSS), version 15. Binary logistic regression analyses were used to identify predictors of poor birth outcomes. P-value ≤ 0.05 was considered statistically significant. Results: All the data resulted from 295 laboring mothers were made part of the analyses. A total of 266 (90.2%) laboring mothers gave live birth. A quarter, 68 (23.1%) of the laboring mothers had a poor birth outcome. The common adverse outcomes were intrauterine fetal death (IUFD, preterm, and birth defects with the proportion of 29 (42.6%), 22 (32.4%), and 3 (4.4%), respectively). Mother whose husband’s occupation was merchant (AOR = 4.4, 95% CI: 1.0-19.0), driver (AOR = 4.2, 95% CI: 1.12-15.76), & women who were illiterate (AOR = 4.0, 95% CI: 1.2-13.5), primary school completed (AOR = 4.3, 95% CI: 1.3-13.8), non-antenatal care visited (AOR = 3.4, 95% CI: 1.12-10.2), rural residence, (AOR = 2.6, 95% CI: 1.11-5.80), & mother’s HIV status, (AOR = 34.2, 95% CL 5.6, 207.0) were independent predictors of poor birth outcomes. Conclusions: Poor birth outcomes were very common in the study area where low birth weight accounted for much of all adverse pregnancy outcomes. Occupation, residence, antenatal care visit, income, maternal education and HIV status were determinants of poor birth outcomes. Accessing antenatal care in early trimester, mild physical work, maternal education to secondary level and above should be encouraged.

Keywords

Birth Outcome; Low Birth Weight; Laboring Mother; North Wollo; Ethiopia

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Hornstra, G., Uauy, R. and Yang, X. (2005) The impact of maternal nutrition on the offspring. Nestlé Nutrition Workshop Series Pediatric Program, Nestec Ltd., Vevey/S. Karger AG, Basel, 1-15.
[2]	Taffa, N. and Obare, F. (2004) Pregnancy and child health outcomes among adolescents in Ethiopia. The Ethiopian Journal of Health Development, 18, 90-95.
[3]	Kent, H., Johnson, K., Curtis, M., Hood, J.R. and Atrash, H. (2006) Atlanta, GA: National center on birth defects & developmental disabilities. Proceedings of the Preconception Health and Health Care Clinical, Public Health, and Consumer Workgroup Meetings, Atlanta, 27-28 June 2006, 30 p.
[4]	Bale, J.R., Stoll, B.J. and Lucas, A.O. (2003) Improving birth outcomes: Meeting the challenges in the developing world. Committee on Improving Birth Outcomes, Board on Global Health, Institute of Medicine of the National Academy of Science, The National Academic Press, Washington DC, 372.
[5]	M. Wiebenga (2007) “Safe Motherhood at Twenty” desk study for share-net. Public Health Consultants, Amsterdam, 1-64.
[6]	Tafari, A., Naeye, R.L. and Gobezie, A. (1980) Effects of maternal under nutrition and heavy physical work during pregnancy on birth weight. British Journal of Obstetrics and Gynaecology, 87, 222-226. doi:10.1111/j.1471-0528.1980.tb04523.x
[7]	Central Statistical Agency and ORC Macro (2006) Ethiopia demographic and health survey 2005. Central Statistical Agency and ICF International, Addis Ababa, Ethiopia and Calverton, Maryland.
[8]	Abel, E.L. and Hunninghan, J.H. (1995) J-shaped’ relationship between drinking during pregnancy & birth weight: Reanalysis of prospective epidemiological data. Alcohol, 30, 345-355.
[9]	Wardlaw, T., Blanc, A., Zupan, J. and Ahman, E. (United Nations Children’s Fund and World Health Organization) (2004) Low birth weight: Country, regional and global estimates. UNICEF, New York.?
[10]	Basso, O., Olsen, J., Knudsen, L., et al. (1998) Pregnancy within 8 months of a previous birth showed an increased risk of preterm delivery. American Journal of Obstetrics & Gynecology, 178, 259-263.
[11]	Scheirer D. and Laflamme, M. (2006) Maternal hemo- globin concentration of pregnancy outcome: A study of effects of elevation in El Alto, Bolivia. Honors Junior/Senior Projects, Paper 29.
[12]	Kirchengast, S. and Hartmann, B. (2007) Short stature is associated with an increased risk of caesarean deliveries in low risk population. Acta Medica Lituanica, 14, 1-6.
[13]	Sanders, D., Reynolds, L., Westwood, T., et al. (2007) Western cape burden of disease reduction project, volume 7 of 7. Decreasing the Burden of Childhood Disease Final Report, 1-4.
[14]	Villar, J. and Bellizan, J.M. (1982) The relative contribution of prematurity and fetal growth retardation to low birth weight in developing and developed societies. American Journal of Obstetrics & Gynecology, 143, 793-798.
[15]	Gebremariam, A. (2005) Factors predisposing to low birth weight in Jimma Hospital South Western Ethiopia. East African Medical Journal, 82, 554-558.
[16]	Nekatibeb, G. and Mariam, A. (2007) Analysis of birth weight in Metu Karl hospital South West Ethiopia. Ethiopian Medical Journal, 45, 195-202.
[17]	Geenwood, A.M., Greenwood, B.M., Bradely, A.K., et al. (1987) A prospective survey of the outcome of pregnancy in a rural area of Gambia. Bullitene of WHO, 5, 635-643.
[18]	Sachdev, H.P.S. (2001) Low birth weight in south Asia Division of Clinical Epidemiology, Department of Pediatrics. Maulana Azad Medical College, New Delhi.
[19]	Siza, J.E. (2008) Risk factors associated with low birth weight of neonates among pregnant women attending a referral hospital in Northern Tanzania. Tanzania Journal of Health Research, 10, 1-8.