Magnitude and Determinants of Immediate Adverse Neonatal Outcomes Among Babies Born by Cesarean Section in Public Hospitals in Harari Region, Eastern Ethiopia

Abstract

Purpose: To determine the magnitude and determinants of immediate adverse neonatal outcomes among babies born by cesarean section in public hospitals in the Harari region, Eastern Ethiopia. Patients and Methods: A prospective follow-up study among 715 eligible babies born by cesarean section in Jegula and Hiwot Fana public hospitals in Harar. Neonate is said to have immediate adverse outcomes if one of the following were detected: (1) baby died, or (2) admitted to NICU, or (3) its primitive reflexes were absent within 24 hours after delivery Adjusted risk ratios (ARRs) and 95% confidence intervals (CIs) were computed using modified Poisson regression. Results: During the follow-up period, a total of 44 babies died, 139 admitted to NICU, and 133 had absent neonatal reflexes. In general, 157 had an adverse neonatal outcome after CS. The following conditions were postively and statistically related with the outcome: estimated household income (ARR 2.19 CI 1.57-3.07), having no Antenatal care (ARR 1.46 1.08--1.97), history of medical or obstetric condition , having an absolute indication for delivery (ARR 1.71 CI 1.28-2.29), presence of meconium (ARR 1.61 CI 1.22-2.12), low birth weight (ARR 1.96 CI 1.42-2.70), and respiratory depression at birth . Conclusion:A fifth of babies developed immediate adverse outcomes after a cesarean section. Several maternal clinical factors were predictors for immediate adverse neonatal outcomes. Assessing previous clinical and obstetric conditions of the women during ANC would help properly plan in averting the occurrence of immediate adverse neonatal outcomes after birth.

Adverse Neonatal Outcome are More Common among Babies Born by Cesarean Section than Naturally Born Babies at Public Hospitals in Eastern Ethiopia: A Comparative Prospective Follow-Up Study at Eastern Ethiopia

“…This result agrees with studies conducted in Australia and Nepal, which indicated that neonatal mortality was higher in nulliparous. 54,55 A research report from the Netherlands also showed that the risk of birth asphyxia doubled in nullipara women than in multiparous. 56 This might be explained by the threat of anemia, CPD, pre-eclampsia, preterm births, vacuum extraction, and low birth weight which are expected in this group of women, leading them to adverse neonatal outcomes.…”

Effect of Decision-to-Delivery Time of Emergency Cesarean Section on Adverse Newborn Outcomes at East Gojjam Zone Public Hospital, Ethiopia, March 2023: Multicenter Prospective Observational Study Design

“…30 Adverse neonatal outcome: Presence of the following fetal outcomes within 48 hours: stillbirth, 1st -minute Apgar score of <7, 5th minutes of Apgar score <7, admission to the NICU, and newborn death. 19,31 Data Collection Tool, Method, and Procedure…”

Magnitude of cesarean-section and associated factors among diabetic mothers in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A cross-sectional study

“…In addition, DM poses multiple risks to pregnant women and their offspring, such as preeclampsia, macrosomia, prematurity, obstructed labor, shoulder dystocia, congenital anomalies, birth injuries, and a consequent increase in obstetric interventions including cesarean-section (3,4). Cesareansection (CS) is a surgical procedure indicated when vaginal delivery presents a higher likelihood of adverse maternal and/or perinatal outcomes (5,6).…”