Predictors of prolonged hospitalization after vaginal birth in Ghana: A comparative study

Abstract

Early discharge after child delivery although indispensable, but maybe precluded by several factors. The effect of these factors on prolonged length of stay (LOS) after vaginal delivery has been sparsely investigated in Ghana. This limits understanding of potential leading indicators to inform intervention efforts and optimize health care delivery. This study examined factors associated with prolonged LOS after vaginal birth in two time-separated cohorts in Ghana. We analyzed data from Ghana’s demographic and health surveys in 2007 and 2017. Our comparative analysis is based on subsamples in 2007 cohort (n = 2,486) and 2017 cohort (n = 8,065). A generalized estimating equation (GEE) with logistic regression was used to examine predictors of prolonged LOS after vaginal delivery. The cluster effect was accounted for using the exchangeable working correlation. The odds ratios (OR) and 95% confidence interval were reported. We found that 62.4% (1551) of the participants in 2007 had prolonged LOS after vaginal delivery, whereas the prevalence of LOS in the 2017 cohorts was 44.9% (3617). This constitutes a 17.5% decrease over the past decade investigated. Advanced maternal age (AOR = 1.24, 95% Cl 1.01–1.54), place of delivery (AOR = 1.18, 95% Cl 1.02–1.37), child’s size below average (AOR = 1.14; 95% Cl 1.03–1.25), and problems suffered during/after delivery (AOR = 1.60; 95% Cl 1.43–1.80) were significantly associated with prolonged (≥ 24 hours) length of hospitalization after vaginal delivery in 2017. However, among variables that were available in 2007, only those who sought delivery assistance from non-health professionals (AOR = 1.89, 95% CI: 1.00–3.61) were significantly associated with prolonged LOS in the 2007 cohort. Our study provides suggestive evidence of a reduction in prolonged LOS between the two-time points. Despite the reduction observed, more intervention targeting the identified predictors of LOS is urgently needed to further reduce post-vaginal delivery hospital stay. Also, given that LOS is an important indicator of medical services use, an accurate understanding of its prevalence and associated predictors are useful in assessing the efficiency of hospital management practices and the quality of care of patients in Ghana.

Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea

“…The present study found maternal complications were an independent determinant of longer LOS following VD. The finding is consistent with Prior literature reports [ 29 , 34 ]. The provision of post-partum care is essential for mothers following childbirth, even more so for mothers who experience complications during labor.…”

Discharge time following natural birth in Uganda: Do non-clinical factors explain the trend?

“…Women who gave birth to big sized children were likely to stay shorter after vaginal delivery compared to those who gave birth to small and average-sized children. The ndings are in agreement with the previous studies which found that women who gave birth to children with a big weight were independently associated with a shorter length of stay compared to those who gave birth to low birth weight children [3,11,25]. This could be because small size children are often premature, which means they may have underdeveloped organs and require additional medical attention.…”

Determinants of maternal length of stay following childbirth in a rural health facility in Eritrea

“…The present study found maternal complication was independent determinant for longer LOS following VD. The nding is consistent with Prior literature reports [28,34]. Provision of post-partum care is essential for mothers following childbirth, even more so for mothers who experience complications during labor.…”