Determinants of obstructed labor among women attending intrapartum care in Amhara Region, Northwest Ethiopia: A hospital-based unmatched case–control study

Abstract

Objectives: maternal and neonatal mortality in Ethiopia is a major reproductive health problem. Obstructed labor is one of the leading causes of maternal, fetal, and neonatal morbidity in developing countries. The evidence regarding its determinants at the tertiary level of care is sparse. Therefore, this study aimed to study the determinants of obstructed labor among women attending intrapartum care in Amhara region referral hospitals. Methods: A Hospital-based unmatched case-control study was conducted from March 1stto August 30, 2017. Cases were women whose labor was obstructed (n = 270), and controls were women whose labor was not obstructed (n = 540). Both cases and controls were selected randomly, and a proportional to size allocation was made to the referral hospitals selected for the study. A binary and a multivariable logistic regression model was computed to identify the determinant factors at 95% CI. Results: The mean age of the study participants was 27.66 years (27.4 ± 5.44 for cases and 28.15 ± 6.16 for controls), ranging between 16 and 45 years. Relatively, higher proportions of cases than controls were unable to read and write (58.5%) and were urban residents (53.7%). Distance from hospital, distance from health center, mothers inability to read and write, mothers primary level of education, more than 28 weeks of gestation at the first visit of antenatal care, 37 to 42 weeks at admission, above 42 weeks at admission, women of a merchant spouse, and history of pregnancy-related complications were the positive determinants of obstructed labor. However, mothers whose gestational age was 16 to 28 weeks at the first antenatal care visit were 62% less likely to be exposed to obstructed labor. Conclusions: Obstetric, service-related, and system factors were predictors of obstructed labor. Improving women’s literacy status, health service access, and utilization will help reduce obstructed labor.

Determinants of obstructed labour and its adverse outcomes among women who gave birth in Hawassa University referral Hospital: A case-control study

“…In addition, the study also indicated that the higher odds of obstructed labour among women who reside within 10-50 kilometers compared to those who reside below 10 kilometers. This finding is in line with studies done in Tanzania [50] and Ethiopia [24,25]. This might be due to the fact that women living close to hospitals get life-saving obstetric information and services in labour earlier, reduce delays from referral and treatment, and reduce maternal morbidity.…”

“…However, studies showed that the burden of obstructed labour and its adverse maternal and perinatal outcomes appear to be high and remain a common challenge in Ethiopia [13,[17][18][19][20][21][22][23]. Different studies conducted across the countries showed that there were different determinants of obstructed labor such as, maternal age, maternal residence, women's education status, women's occupational status [24], distance from the hospital /health center, parity, antenatal visit, weeks of gestation at the first visit of antenatal care [24], age at first birth, fetal presentation, history of pregnancy-related complications and birth weight [13,19,25].…”

Incidence, causes, and maternofetal outcomes of obstructed labor in Ethiopia: systematic review and meta-analysis

“…Among sixteen studies thirteen were cross sectional [1,14,[35][36][37][38][39][40][41][42][43][44][45] and three case-controls [46][47][48] in study design. Regarding the geographical area, six from Oromia [14,35,36,40,41,47], four [3,37,39,42] from Southern Nation Nationalities and People (SNNPR), and four [1,38,43,48] from Tigray region, two studies [45,46] were from Amhara region. Among the included studies the largest sample size was 13,425 [41], whereas the smallest was 90 [48] (Table 1).…”

“…Primarily, all three case-control [46][47][48] studies were not considered in the incidence estimation, because they did not report the incidence of obstructed labor, but all studies were included in factor analysis. The pooled incidence of obstructed labor is presented on a forest plot (Fig.…”

Prevalence, causes, and factors associated with obstructed labour among mothers who gave birth at public health facilities in Mojo Town, Central Ethiopia, 2019: A cross-sectional study

“…According to the scientific facts, socio-demographic features, obstetric characteristics, and healthcare facility-related factors were shown to be associated with OL. The age of the mother, place of residence, and level of education were socio-demographic features associated with OL [ 1 , 4 , 21 – 24 ]. Based on obstetrical factors, gravidity, frequency of antenatal visits, and birth to big baby were all associated with OL [ 1 , 22 – 26 ].…”