ObjectiveThe aim of this study was to assess the socioeconomic and demographic factors on adverse pregnancy outcomes.ResultThe mean age of cases was 42.2 (± 13.26) years and the mean age of controls was 34.5 (± 12.23) years. Advanced maternal age, low educational status, and early sexual debut showed a significant association with an adverse pregnancy outcome. Mothers in the age group 35–44 years, AOR 2.54 (95% CI 1.27, 5.06), 35–44 years, AOR 2.79 (95% CI 1.27, 6.16) and Mothers with age 55 years and above AOR 4.18 (95% CI 1.73, 9.13) were more likely to have an adverse pregnancy outcome compared to mothers in the age group ≤ 24 years. The low educational status was also found to have an implication on adverse pregnancy outcome. Those mothers with no formal education were two times more likely to develop adverse pregnancy outcome AOR 2.15 (95% CI 1.41, 2.81) and those in primary education AOR 1.6 (95% CI 1.06, 4.6) times more likely compared to those in higher education.

Background Early and appropriate antenatal care practices have the potential to save the lives of mothers and their children, and enable mothers to receive the full range of antenatal care services. However, in developing countries, including Ethiopia, a number of pregnant women do not attend antenatal care in the recommended time period. Therefore, this article assessed the timing and factors associated with early antenatal care visits in west Gojjam, northwest Ethiopia. Methods An institution-based cross-sectional study was conducted among pregnant women attending antenatal care services in west Gojjam. Data on participants' sociodemographic, obostetric and reproductive health information were collected from 820 participants using a structured interviewer-administered pretested questionnaire. Bivariate and multivariate logistic regression analyses were used to identify variables associated with early antenatal care visits. Variables with P<0.05 were considered significant. A visit was considered ‘early’ if a pregnant woman attended their first antenatal care session within the first 12 weeks of gestation. Results Almost a third (31.5%) of mothers started antenatal care early. The mean gestational age at the first visit was 17 weeks (standard deviation±7.7), with a range of 3–36 weeks. In multivariate analysis, it was found that being nulliparous (adjusted odds ratio: 2.3; P=0.013), travel time to the health facility being less than 30 minutes (adjusted odds ratio: 6.1; P<0.001) and living in an urban area (adjusted odds ratio: 2.4; P=0.001) were significantly associated with attending antenatal care early. Conclusions Early first antenatal care attendance was low in the study area. It is important to decentralise the provision of antenatal care services at health posts through an outreach service, by strengthening the mobilisation, screening and early referral system through health extension workers and the women development army. This will allow more women to receive antenatal care from skilled providers.

Background/Aims Maternity waiting homes are temporary shelters for pregnant women located near a hospital or health centre and are designed to reduce adverse maternal and perinatal outcomes. However, studies assessing the association between maternity waiting home use and adverse pregnancy outcomes are limited. This study assessed the association between maternity waiting home use and adverse pregnancy outcomes in northwest Ethiopia. Methods A prospective cohort study was conducted among women attending antenatal care in public health facilities in West Gojjam, northwest Ethiopia. Pregnant women (28 weeks or more gestation) were enrolled and followed up until birth. Maternity waiting home use was classified as if a pregnant woman stayed for at least 1 week in a maternity waiting home before birth. Log-binomial regression analysis was used to calculate the effect of maternity waiting homes on adverse pregnancy outcomes and to control the effect of potential confounders. Results A total of 810 women completed follow up and were included in the analysis. The incidence of composite adverse pregnancy outcomes was lower among maternity waiting home users compared to non-users (16.3% vs 24.5%). Maternity waiting home users had a lower risk of perinatal death (P=0.003), low birth weight (P=0.004) and preterm birth (P=0.007) than non-users. There were no significant differences in the risk of prolonged labour and postpartum haemorrhage between maternity waiting home users and non-users. Conclusions Staying in a maternity waiting home was significantly associated with a lower risk of perinatal death, low birth weight and preterm birth, and maternity waiting home users had approximately 50% lower adverse perinatal outcomes than non-users. Therefore, the Amhara Regional Health Bureau, zonal health departments, district health offices and other stakeholders should strengthen the use of maternity waiting homes.