DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20194879

Predictors of poor maternal and perinatal outcome among singleton maternal delivery referral cases to the obstetrics unit of a tertiary health facility in Port Harcourt, Nigeria

Peter A. Awoyesuku, Dagogo A. Mac Pepple

Abstract


Background: The high maternal and perinatal mortality rates in Nigeria continue to be issues of concern. That antenatal care improves both perinatal and maternal outcomes is now well established. The study seeks to identify the predictors of poor maternal and perinatal outcome among singleton maternal delivery cases referred to Rivers State University Teaching Hospital (RSUTH).

Methods: A longitudinal study was employed; the patients referred to RSUTH were followed up to ascertain maternal and neonatal outcomes. A sample size of 460 was used. Selection of cases was done by systematic sampling. Data obtained in the study were demographic, obstetric and perinatal findings. Maternal and perinatal outcome were dichotomized into poor and good outcomes. Bivariate and multivariate analyses were performed using SPSS version 20.0.

Results: A total of 460 cases were recruited. The mean age±SD was 28.7±4.6 years. There was poor maternal outcome in 65 (14.1%) and poor perinatal outcome in 291 (63.3%). There was one maternal death (rate 0.2%), perinatal mortality rate was 26.5%, low birth-weight rate was 6.3% and asphyxia rate was 23.3%. There is an association of multiparity and unbooked status with poor maternal outcome, while poor perinatal outcome was influenced by unbooked status.

Conclusions: Perinatal and maternal mortality were high amongst all referral cases. There is a positive correlation of multiparity with poor maternal outcome and between unbooked status and an increased risk of both maternal and perinatal adverse outcomes.


Keywords


Maternal outcome, Perinatal outcome, Predictors, Referral cases, Unbooked

Full Text:

PDF

References


Hill K, Abouzahr C, Wardlaw T. Estimates of maternal mortality for 1995. Bulletin World Health Organization. 2001;3:182-93.

Buckens P. Is estimating maternal mortality useful? Bulletin World Health Organization. 2001;79:3.

Fasubaa OB, Oguniyi SO, Ezechi OC. Maternal mortality in Obafemi Awolowo University Teaching Hospital Complex Ile-Ife - a compares of maternal death in young and older women. Nig J Med. 2000:4;147-51.

Okonta PI, Okali UK. Otoide VO, Twomey D. Exploring the causes of and risk factors for maternal deaths in a rural Nigerian referral hospital. J Obstete Gynaecol. 2002;22:626-9.

Nwobodo EL. Obstetric emergencies as seen in a tertiary health institution in North-Western Nigeria: maternal and foetal outcome. Nigerian Medical Practitioner. 2006;49:54-5.

Ekwempu CC. The influence of antenatal care on pregnancy outcome. Trop J Obstet Gynaecol. 1988;1:67-71.

Greenberg R. The impact of prenatal care in different social groups. Am J Obstet Gynecol. 1983;145:797-801.

Conde A, Belizan JM, Diaz JL. Epidemiology of fetal death in Latin America. Acta Obstet Gynecol Scand. 2000;79:371-8.

World Health Organization. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. Geneva: WHO; 2010. Available at: https:// www. who. int/ healthinfo/ systems/WHO_MBHSS_2010_full_ web.pdf. Accessed on 10 August 2019.

Drife J. Maternal mortality. In: Lueslay DM, Baker PN. Obstetrics and Gynaecology and Evidence-Based Text for MRCOG. 1st edition. Arnold Publishers; 2004:196-204.

Chukwudebelu WO. Preventing maternal mortality in developing countries, In: Okonofua A, Odunsi K, editors. Contemporary Obstetrics and Gynaecology for Developing Countries. Women’s Health Act Res Centre. 2003:644-657.

Ukpong DI, Owolabi AT. Psychiatric morbidity associated with caesarean section: a study from Wesley Guild Hospital, Ilesa. Nigeria J Obste Gynaecol. 2004;28:891-4.

Etuk SJ, Etuk IS, Ekott MI, Udoma EJ. Perinatal outcome in pregnancies booked for antenatal care but delivered outside health facilities in Calabar, Nigeria. Acta Trop. 2000;24:745-9.

Katz DL, Wild DMG, Elmore JG, Lucan SC. Sample size calculation for epidemiological studies. Jekel’s Epidemiology, Biostatistics, Preventive Medicine and Public Health. 4th ed. Philadelphia: Saunders / Elsevier. 2014:155.

Sabale U, Patankar AM. Study of maternal and perinatal outcome in referred obstetrics cases. J Evolution Med Dental Sci. 2015;4:4448-55.

Owolabi AT, Fatusi AO, Kuti O, Adeyemi A, Faturosi SO, Obiajuwa PO. Maternal complications and perinatal outcomes in booked and unbooked Nigerian mothers. Singapore Med J. 2008;49:526-31.

Khatoon A, Hasny SF, Irshad S, Ansari J. An audit of obstetrics referral to Abbasi Shaheed Hospital. Pak J Surg. 2011;27:304-8.

Blondel B, Dutilh P, Delour M, Uzan S. Poor antenatal care and pregnancy outcome. European J Obst Gynecol Reprod Biol. 1993;50:191-6.

Charu R, Kamal G, Neelu S. Review of referred obstetric cases: maternal and perinatal outcome. Bombay Hosp J. 2010;52:1.