Risk Factors of Antepartum Hemorrhage Among Mothers Who Gave Birth at Suhul General Hospital, 2016: A Case–Control Study

Abstract

Background Antepartum hemorrhage is a very serious problem and contributes significantly to maternal and neonatal morbidity and mortality in developing countries including Ethiopia. Identification of risk factors of antepartum hemorrhage will help for prevention and control programs. Methods An institutional-based case–control study was conducted from July 2013 to June 2016. A simple random sampling technique was employed, and 420 mothers’ medical cards were reviewed using a pretested checklist. The data were entered in to EPI-info version 7 and then exported to SPSS version 20 for analysis, and all variables with a P -value<0.2 at bivariate logistic regression analysis were considered as a candidate for multivariate logistic regression analysis, and those variables with a P -value<0.05 in multiple logistic regression analysis were considered as significantly associated at 95% confidence interval. Results Results of the multiple logistic regression showed that those mothers whose age was in the range of 35–44 years were significantly 4-times more likely to present with antepartum hemorrhage as compared to mothers in the age range of 15–24 years. Moreover, mothers who presented with a previous history of cesarean section were 4.7-times more likely to present with antepartum hemorrhage than those who had no previous history of cesarean section. Furthermore, women with a previous history of abortion were 2-times more likely to develop antepartum hemorrhage as compared to women who had no previous history of abortion. Conclusion and Recommendation In this study, the factors found to be risk factors of antepartum hemorrhage were maternal age, previous history of cesarean section, and previous history of abortion. Strategies towards reduction of unwanted pregnancy to prevent abortion, pregnancy at advanced age, and to reduce the cesarean section rate should be emphasized.

Influence of health system factors on Fetomaternal outcomes among pregnant women presenting with antepartum hemorrhage at Jaramogi Oginga Odinga Teaching and Referral Hospital, Kisumu-Kenya

“…That is comparable to a study done in Kenyatta Hospital that had the highest level at secondary level for patients with APH (Njoroge, Pinckie L N 2017). Our study finding was also similar to a study done in India that reported cases of APH that were illiterate to be 45.1% (Dibaba B, 2021). From the study, literacy levels are a major determinant of maternal and neonatal outcomes with patients with higher qualifications exhibiting better outcomes for both the control and case groups.…”

“…This is opposed to a study done in India that recorded high parity as a risk to APH. (Dibaba B, 2021).…”

Perinatal asphyxia and associated factors among neonates admitted to a specialized public hospital in South Central Ethiopia: A retrospective cross-sectional study

“…Significant evidence reveals [ 15 , 39 , 40 ] that the occurrence of antepartum bleeding results in a decreased blood flow from the mother to the placenta with subsequent hypoxia to the fetus. Studies conducted in Ethiopia have also shown an increased incidence of perinatal asphyxia among mothers who encountered APH [ 15 , 40 ]. This study also identified that antepartum hemorrhage was associated with perinatal asphyxia, consistent with the study conducted in Bangalore, Indonesia [ 41 ], and Accra Ghana [ 34 ].…”

“…Studies conducted in India [29], Bangkok Rajavithi hospital [37], Gusau Nigeria [38], and Tigray Ethiopia [23] are in line with this data. Significant evidence reveals [15,39,40] that the occurrence of antepartum bleeding results in a decreased blood flow from the mother to the placenta with subsequent hypoxia to the fetus. Studies conducted in Ethiopia have also shown an increased incidence of perinatal asphyxia among mothers who encountered APH [15,40].…”

“…These could be summarized into abnormal maternal oxygenation, congenital infections, insufficient placental perfusion, traumatic deliveries, or impaired umbilical circulation. Most studies identified that intrapartum factors as having the highest impact [ 7 , 14 , 15 ].…”