Perinatal Morbidity and Mortality in Late and Post Term Pregnancy in Three Teaching Hospital Addis Ababa, Ethiopia: a Facility Based Comparative Cross-Sectional Study
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Date
2023-08
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Addis Ababa University
Abstract
Background: The early term and full term pregnancy is defined as that occurring between37+0-40+6 weeks of gestation. Pregnancies with duration outside of this range are associated withperinatal morbidity and mortality. Assessment of the prevalence of adverse out comes betweenterm, late term and post term deliveries helps to reduce perinatal morbidity and mortality associated with late term and post term pregnancies.
Objective: To assess and compare the perinatal out comes of pregnancies at early term, fullterm, late term and post term
Method: A facility based comparative cross-sectional study was carried out on 654 pregnantwomen & their newborns delivered at gestational age of 37+0 weeks & more weeks of gestationat the three teaching hospital in Addis Ababa: Tikur Anbesa, Gandhi Memorial and ZewdituMemorial Hospital. In the study the prevalence rates of adverse perinatal outcomes for eachgestational age group were estimated. Data was collected by trained data collectors using apretested structured questionnaire developed from available relevant literature. Data was checkedfor completeness, cleaned, entered, and analysed by principal investigators using SPSS version25. Binary and multiple logistic regression analysis were done to see the association of variables.
Result: There was significant statistical differences in the rate of meconium aspiration syndrome(p-0.039), cesarean section (p-0.027) and macrosomia (p -0.038). The rate of cesarean sectionwas more frequent in group 3(GA ≥42 weeks) compared with group 2(GA 41-41+6 week) (40%;versus 30.9 % P=0.038) frequency of meconium aspiration syndrome and macrosomia were nosignificant difference in group 2 compared with group 3. Results were also compared betweengroup 1(GA 37-40+6week) and group 3(GA ≥ 42 weeks(table 7).The frequency of meconiumaspiration syndrome was lower in group 1 compared with group 3(4.1 % versus 5.1%; p=0.023),the rate of cesarean section was more frequent in group 3 compared with group 1(42.2 %versus31.4%;p=0.013), and macrosomia was lower in in group 1 compared to group 3 (5% versus15%;p=0.022).There were no significant difference in the rate perinatal asphyxia, respiratory distress syndrome ,neonatal intensive care unit , early onset of sepsis and APGAR score less than7 in 5th minute in group 1 and group3.
Conclusion: This study showed that participants whose gestational age of post term hadincreased adverse perinatal outcomes than Gestational age of term (GA 37-40+6.) and late term pregnancies. A significant increased risk of perinatal complication like MAS, NICU admission,caesarean delivery and macrosomia observed in GA ≥ 42 weeks compared with 37+0-40+6 weeks’gestation and late term pregnancies.
Recommendation: To decrease the perinatal adverse outcomes in post term pregnancy induction
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Morbidity and Mortality