Adverse maternal outcomes among women who gave birth at public hospitals in eastern Ethiopia: a cross-sectional study.
Study Goal
The researchers aimed to determine whether folic acid intake during pregnancy was associated with reduced risk of adverse maternal outcomes in women giving birth in eastern Ethiopia.
Results Summary
Folic acid intake during pregnancy significantly reduced the risk of adverse maternal outcomes (ARR = 0.47; 95% CI: 0.38-0.57), demonstrating a protective effect. The study did not report adverse effects or safety concerns related to folic acid.
Population
Women who gave birth in six public hospitals in eastern Ethiopia (n=2,608).
Effective Dosage
Not specified
Duration
Duration of pregnancy (exact length not specified)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
poor wealth index | increase | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 4.41; 95% CI: 3.46-5.62 | increased the risk | #1 |
having danger signs at admission | increase | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 1.86; 95% CI: 1.18-2.91 | increased the risk | #2 |
alcohol use during pregnancy | increase | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 1.86; 95% CI: 1.32-2.62 | increased the risk | #3 |
duration of labor ≥24 h | increase | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 1.69; 95% CI: 1.00-2.85 | increased the risk | #4 |
maternal age greater than 35 years | increase | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 1.39; 95% CI: 1.03-1.86 | increased the risk | #5 |
folic acid intake during pregnancy | decrease | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 0.47; 95% CI: 0.38-0.57 | reduced the risk | #6 |
having partner support | decrease | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 0.70; 95% CI: 0.59-0.83 | reduced the risk | #7 |
spontaneous vaginal delivery | decrease | adverse maternal outcomes | women who gave birth at selected public hospitals in eastern Ethiopia | ARR = 0.58; 95% CI: 0.49-0.68 | reduced the risk | #8 |
BACKGROUND: An adverse maternal outcome, such as anemia, postpartum hemorrhage, and postpartum eclampsia, poses a significant risk to women. While studies on the burden of adverse maternal outcomes have been conducted in various countries, including Ethiopia, many predictors beyond obstetric factors have not been fully explored. This study aimed to determine the magnitude and factors associated with adverse maternal outcomes among women who gave birth at selected public hospitals in eastern Ethiopia. METHODS: A hospital-based cross-sectional study was conducted among 2,608 randomly selected women who gave birth in six public hospitals in eastern Ethiopia from November 2023 to March 2024. Data were collected through face-to-face interviews and clinical chart reviews. Factors associated with adverse maternal outcomes were identified using bivariable and multivariable robust Poisson regression analyses. Adjusted relative risk (ARR) with a 95% confidence interval (CI) was used to report the strength of the association. The variables with a p-value of <0.05 were considered statistically significant. RESULTS: The magnitude of adverse maternal outcomes was 15.68% (95% CI: 14.70%-16.66%). A poor wealth index (ARR = 4.41; 95% CI: 3.46-5.62), having danger signs at admission (ARR = 1.86; 95% CI: 1.18-2.91), alcohol use during pregnancy (ARR = 1.86; 95% CI: 1.32-2.62), duration of labor ≥24 h (ARR = 1.69; 95% CI: 1.00-2.85), and maternal age greater than 35 years (ARR = 1.39; 95% CI: 1.03-1.86) increased the risk of adverse maternal outcomes. In contrast, folic acid intake during pregnancy (ARR = 0.47; 95% CI: 0.38-0.57), having partner support (ARR = 0.70; 95% CI: 0.59-0.83), and spontaneous vaginal delivery (ARR = 0.58; 95% CI: 0.49-0.68) reduced the risk of adverse maternal outcomes. CONCLUSION: One in six women who gave birth in eastern Ethiopia experienced adverse maternal outcomes. This rate was determined to be moderate when compared to the WHO projections for lower- and middle-income countries and better than the higher averages reported by the WHO. Targeted intervention programs, such as targeted education and empowerment programs, and the strengthening of the community health worker program would help address socioeconomic disparities and improve early detection and management of danger signs during pregnancy, which would aid in averting the occurrence of adverse outcomes.