Adverse obstetric outcomes in public hospitals of southern Ethiopia: the role of parity

Direct obstetric causes have a significant contribution for severe maternal morbidities and mortalities, although the effect of grand multiparity on adverse obstetric outcomes remains controversial across studies. This study aimed to compare obstetric outcomes in grand multiparous and low multiparous women in two hospitals of southern Ethiopia. A comparative cross-sectional study was conducted in one general and one comprehensive specialized hospitals in 2018. Four hundred and sixty-one mothers were included in the study. Data were collected by structured questionnaire and extraction sheets from clinical documents, and were analyzed using STATA version 14 (StataCorp, College Station, TX, USA). About 39% of the included mothers had at least one adverse obstetric outcome. Hypertensive disorders of pregnancy, antepartum hemorrhage, and premature rupture of membrane and were higher in the grand multiparous mothers. However, obstructed labor and risk of cesarean delivery were higher in low multiparous women. History of medical illnesses, previous cesarean delivery, and high birth weight were independent predictors of adverse maternal outcomes regardless of parity. However, parity did not show statistically significant difference in obstetric outcomes. Parity did not show statistically significant difference in experiencing adverse obstetric outcomes in women. Early identification and treatment of high-risk mothers is recommended regardless of parity.

直接产科病因是严重孕产妇发病率与死亡率的重要诱因，尽管多产次（grand multiparity）对不良产科结局的影响在各相关研究中仍存在争议。本研究旨在对比埃塞俄比亚南部两所医院内多产次产妇与低产次产妇的产科结局。本研究于2018年在一所综合医院与一所全面专科医院开展对比性横断面研究，共纳入461名产妇。研究采用结构化调查问卷与临床文档提取表收集数据，并使用Stata 14版本（美国德克萨斯州学院站Stata公司）进行数据分析。纳入产妇中约39%至少出现1项不良产科结局。妊娠期高血压疾病、产前出血与胎膜早破的发生率在多产次产妇中更高；然而，梗阻性分娩与剖宫产术风险在低产次产妇中更高。无论产次如何，既往病史、既往剖宫产史与新生儿高出生体重均为不良孕产妇结局的独立预测因素。然而，产次与产科结局未呈现统计学显著差异；产妇产次与不良产科结局的发生风险亦未存在统计学显著差异。无论产次如何，均建议早期识别并干预高危产妇。