Cheryl A Moyer1, Candace K Kolars2, Samuel A Oppong3, Ashura Bakari4, April Bell5, Priscilla Busingye6. 1. Global REACH and Departments of Learning Health Sciences and Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: camoyer@umich.edu. 2. Office of Performance Assessment and Clinical Effectiveness, University of Michigan Health System, Ann Arbor, MI, USA. 3. Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Accra, Ghana. 4. Ghana Health Service, Kumasi, Ghana. 5. School of Public Health, University of Michigan, Ann Arbor, MI, USA. 6. Department of Obstetrics and Gynecology, Virika Hospital, Fort Portal, Uganda.
Abstract
OBJECTIVE: To explore pregnancy outcomes at a referral hospital in rural western Uganda. METHODS: A retrospective study was undertaken using data for all deliveries at Virika Hospital, Fort Portal, Uganda, between July 1, 2009, and October 22, 2011. A detailed review of delivery logs was conducted. Categories were created for obstetric risk factors (e.g. grand multipara, history of hypertension), maternal delivery complications (e.g. eclampsia, hemorrhage), and neonatal complications (e.g. fetal distress, birth defects). RESULTS: Overall, 4883 deliveries were included. Of the 517 neonates who did not survive, 430 (83.2%) had been stillborn. After controlling for parity, gestational age, obstetric risk factors, and neonatal complications, risk factors for stillbirth included maternal delivery complications (risk ratio [RR] 3.32, 95% confidence interval [CI] 2.34-4.71; P<0.001) and living 51-100km from the hospital (RR 3.37, 95% CI 2.41-4.74; P<0.001). Risk factors for neonatal death included neonatal complications (RR 5.79, 95% CI 2.49-13.46; P=0.001) and maternal delivery complications (RR 3.17, 95% CI 1.47-6.82; P=0.003). CONCLUSION: Qualified providers need to be deployed to rural areas of Uganda to facilitate the prompt identification and management of pregnancy, delivery, and neonatal complications.
OBJECTIVE: To explore pregnancy outcomes at a referral hospital in rural western Uganda. METHODS: A retrospective study was undertaken using data for all deliveries at Virika Hospital, Fort Portal, Uganda, between July 1, 2009, and October 22, 2011. A detailed review of delivery logs was conducted. Categories were created for obstetric risk factors (e.g. grand multipara, history of hypertension), maternal delivery complications (e.g. eclampsia, hemorrhage), and neonatal complications (e.g. fetal distress, birth defects). RESULTS: Overall, 4883 deliveries were included. Of the 517 neonates who did not survive, 430 (83.2%) had been stillborn. After controlling for parity, gestational age, obstetric risk factors, and neonatal complications, risk factors for stillbirth included maternal delivery complications (risk ratio [RR] 3.32, 95% confidence interval [CI] 2.34-4.71; P<0.001) and living 51-100km from the hospital (RR 3.37, 95% CI 2.41-4.74; P<0.001). Risk factors for neonatal death included neonatal complications (RR 5.79, 95% CI 2.49-13.46; P=0.001) and maternal delivery complications (RR 3.17, 95% CI 1.47-6.82; P=0.003). CONCLUSION: Qualified providers need to be deployed to rural areas of Uganda to facilitate the prompt identification and management of pregnancy, delivery, and neonatal complications.
Authors: Francisca S Chuwa; Amasha H Mwanamsangu; Benjamin G Brown; Sia E Msuya; Elizabeth E Senkoro; Oresta P Mnali; Festo Mazuguni; Michael J Mahande Journal: PLoS One Date: 2017-08-15 Impact factor: 3.240