Adverse pregnancy outcome and its association with the various determinants of current pregnancy in a district hospital, urban Bengaluru, India

Darshan Hoysanahalli Shivashankarappa; Neha Annet Joy; Sangeetha M. D.

doi:10.18203/2394-6040.ijcmph20240623

Authors

Darshan Hoysanahalli Shivashankarappa Department of Community Medicine, ESIC Medical College and PGIMSR and Model Hospital, Rajajinagar, Bangalore, Karnataka, India
Neha Annet Joy Department of Community Medicine, M. S. Ramaiah Medical College, Bangalore, Karnataka, India
Sangeetha M. D. Department of Community Medicine, ESIC Medical College and PGIMSR and Model Hospital, Rajajinagar, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20240623

Keywords:

Adverse pregnancy outcomes, Antenatal care, Caesarean section, Institutional delivery, Maternal health

Abstract

Background: Maternal health is a crucial aspect of public health, directly influencing pregnancy outcomes. Adverse outcomes, such as miscarriage, stillbirth, cesarean delivery, and abortion, reflect poor maternal health and contribute to maternal mortality and infant mortality rates. Antenatal care (ANC) and institutional delivery are pivotal strategies to mitigate maternal and fetal complications. However, the escalating rates of cesarean sections in India, surpassing the WHO-recommended threshold, present a severe public health challenge.

Methods: This retrospective cross-sectional study, conducted in urban Bengaluru from January to July 2023, aimed to identify adverse pregnancy outcomes and their determinants among women aged 15 to 49 in India. Data from maternal birth and labor records were analyzed, encompassing sociodemographic factors, obstetric characteristics, and adverse outcomes.

Results: The study revealed a 20.8% magnitude of adverse pregnancy outcomes. It was found to be higher among women in the age group above 30 years, multigravida, have low blood pressure (BP) both systolic and diastolic, B blood group, positive Rh type, a male baby. In bivariate analysis, higher odds were observed among women in the 30-49 age group, body mass index overweight category, active management of the third stage of labor, and delayed cord clamping were found to be statistically significant.

Conclusions: The study underscores the urgency for an expanded action plan to enhance maternal healthcare in India. While governmental initiatives exist, there remains a pressing need to address unnecessary caesarean deliveries and associated complications. The findings advocate for heightened awareness, community health worker training, and stringent guidelines on the necessity of caesarean sections.

Metrics

Metrics Loading ...

References

Patel KK, Saroj RK, Kumar M. Prevalence and determinants of adverse pregnancy outcomes among women in India: A secondary data analysis. Indian J Community Med. 2021;46(3):434.

Kuppusamy P, Prusty RK, Chaaithanya IK, Gajbhiye RK, Sachdeva G. Pregnancy outcomes among Indian women: increased prevalence of miscarriage and stillbirth during 2015-2021. BMC Pregnancy Childbirth. 2023;23(1):1-9.

National Family Health Survey (NFHS-5), 2019-21 for India. Ministry of Health and Family Welfare. Available from: https://main.mohfw.gov.in/sites/ default/files/NFHS-5_Phase-II_0.pdf. Accessed on 3 January 2024.

Singh M, Sonkaria LK, Raghav P. Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): new initiative to deliver quality maternal health care in India. MOJ Womens Health. 2017;4(2):00081.

Ahmed I, Ali SM, Amenga-Etego S, Ariff S, Bahl R, Baqui AH, et al. Population-based rates, timing, and causes of maternal deaths, stillbirths, and neonatal deaths in south Asia and sub-Saharan Africa: a multi-country prospective cohort study. Lancet Global Health. 2018;6(12):e1297-308.

Altijani N, Carson C, Choudhury SS, Rani A, Sarma UC, Knight M, et al. Stillbirth among women in nine states in India: rate and risk factors in study of 886,505 women from the annual health survey. BMJ Open. 2018;8(11):e022583.

Feodor Nilsson S, Andersen PK, Strandberg‐Larsen K, Nybo Andersen AM. Risk factors for miscarriage from a prevention perspective: a nationwide follow‐up study. BJOG. 2014;121(11):1375-85.

Betrán AP, Torloni MR, Zhang JJ, Gülmezoglu AM, Aleem HA, Althabe F, et al. WHO statement on caesarean section rates. BJOG. 2016;123(5):667.

Ronsmans C, Holtz S, Stanton C. Socioeconomic differentials in caesarean rates in developing countries: a retrospective analysis. Lancet. 2006;368(9546):1516-23.

Torloni MR, Betran AP, Souza JP, Widmer M, Allen T, Gulmezoglu M, et al. Classifications for cesarean section: a systematic review. PloS One. 2011;6(1):e14566.

Roy N, Mishra PK, Mishra VK, Chattu VK, Varandani S, Batham SK. Changing scenario of C-section delivery in India: Understanding the maternal health concern and its associated predictors. J Fam Med Prim Care. 2021;10(11):4182.

Gondwe T, Betha K, Kusneniwar GN, Bunker CH, Tang G, Simhan H, et al. Adverse infant outcomes associated with caesarean section delivery in India. Int Health. 2020;12(5):411-6.

Khanal V, Karkee R, Lee AH, Binns CW. Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study. Reprod Health. 2016;13:1-6.

Sikder SS, Labrique AB, Shamim AA, Ali H, Mehra S, Wu L, et al. Risk factors for reported obstetric complications and near misses in rural northwest Bangladesh: analysis from a prospective cohort study. BMC Pregnancy Childbirth. 2014;14:1-3.

Tamirat KS, Sisay MM, Tesema GA, Tessema ZT. Determinants of adverse birth outcome in sub-Saharan Africa: analysis of recent demographic and health surveys. BMC Public Health. 2021;21(1):1-10.

Worku AG, Yalew AW, Afework MF. Maternal complications and women's behavior in seeking care from skilled providers in North Gondar, Ethiopia. PloS One. 2013;8(3):e60171.

Chaibva BV, Olorunju S, Nyadundu S, Beke A. Adverse pregnancy outcomes, ‘stillbirths and early neonatal deaths’ in Mutare district, Zimbabwe (2014): a descriptive study. BMC Pregnancy Childbirth. 2019;19:1-7.

Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, et al. Short-term and long-term effects of caesarean section on the health of women and children. Lancet. 2018;392(10155):1349-57.

Mishra VK. Geo-spatial analysis of cesarean section in India. OAJ Gerontol Geriatr Med. 2019;5:555658.

Balkus JE, Neradilek M, Fairlie L, Makanani B, Mgodi N, Mhlanga F, et al. Assessing pregnancy and neonatal outcomes in Malawi, South Africa, Uganda, and Zimbabwe: results from a systematic chart review. PloS One. 2021;16(3):e0248423.

Yimer NB, Gedefaw A, Tenaw Z, Liben ML, Meikena HK, Amano A, et al. Adverse obstetric outcomes in public hospitals of southern Ethiopia: the role of parity. J Matern Fet Neonat Med. 2022;35(10):1915-22.