Predictors of Maternal Mortality among Mothers Who Delivered In Selected Public Hospitals in Addis Ababa, Ethiopia: Unmatched Case Control Study
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Date
2022-06
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Addis Ababa University
Abstract
Background: Maternal mortality ratio in Ethiopia is one of the highest in the world. Despite measures to alleviate it and showing a promising declining trend, it still remains one of the highest at 401 nationally maternal deaths per 100,000 live births in 2017. The maternal death risks have been known to be associated with different socio-demographic and obstetric factors. This study aimed at assessing the predictors of maternal mortality among mothers delivered in selected public health hospitals in Addis Ababa, Ethiopia using unmatched case control design.
Objectives: To determine predictors of maternal mortality among mothers who had given birth the last three years in the selected public hospitals of Addis Ababa Ethiopia.
Methods: A case control study was conducted on pregnant mothers admitted to Addis Ababa selected public hospitals (St. Paul Hospital Millennium Medical College, Ghandi Memorial Hospital, and Zewditu Hospitals) for delivery from the past three years 2019 to 2021, data was collected from May 1-May 30/2022. Cases were pregnant mothers admitted to delivery and died, while controls were those who survived. A total sample size for this study was 245, of which 49 cases and 196 controls were proportionately allocated to each hospital. Data were collected from delivery registration logbook, death reports and referral papers. Data were analyzed by descriptive analysis and also logistic regression analysis used to see association between different characteristics and maternal mortality, controlling for confounders. The association was measured using crude and adjusted odds ratios (ORs), with 95% CI and p-value <0.05 as used to determine the presence of a statistically significant association.
Result: From the total of 245 study participants 49 were cases and 196 controls, all included in the analysis (100%). The mean age of cases were 32.6(±SD3.5). The mode of delivery (C/S) (AOR=4.86, 95% CI (1.18-14.94), mothers age being above 35(AOR=2. 11, 95% CI (1.15-7.10), being referred from other health facility (AOR=3.16, 95% CI (1.87-7.76), having history of no ANC (AOR=3.65, 95% CI (1.53-13.34) and having any chronic illness (AOR=9.54, 95% CI(6.54-17.38) were found to be factors that showed a statistically significant association with maternal mortality. The most common causes of death were postpartum hemorrhage, sepsis, retained placenta, post-operative complications and anemia.
Conclusion and recommendation: Caesarean delivery, older maternal age, being referred from another facility, having no ANC in previous delivery and having any chronic illness were Predictors for maternal mortality. As some of these factors were modifiable factors, identifying risky groups and designing targeted interventions must be given emphasis by stake holder.
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Keywords
Mode of delivery, Maternal Mortality, Caesarean Section