Pattern of maternal and perinatal complications at delivery in a Tertiary Hospital in North-Western Nigeria

Abstract

Background: Maternal and perinatal healths are very important public health issues. The availability and quality of health care delivery systems of any nation is its maternal and perinatal mortality statistics. Objective: To determine the pattern of maternal and perinatal morbidities among mothers who are booked for antenatal care in Aminu Kano Teaching Hospital and those who did not and to determine the factors which contribute to these outcomes. Methods: Women who did not have antenatal care (unbooked mothers) at Aminu Kano Teaching Hospital and those who had (booked mothers) between 1 July, 2006 and 31 June, 2009, were retrospectively studied for maternal complications and perinatal outcome. The indices of outcome measured in this study were Caesarean section rates, antepartum eclampsia, antepartum haemorrhage, postpartum haemorrhage, low birth weight, low Apgar scores, stillbirth, and foetal macrosomia. Both groups had their deliveries supervised at Aminu Kano Teaching Hospital. The data between the two groups were compared.Results: A total of 11,035 deliveries were conducted during the study period. Of these, 8,292(75%) were booked while 2,743(25%) of total deliveries were unbooked.Amongthe booked group, 6,363 files were retrieved giving a file retrieval rate of 76.7% while in the unbooked group, 1,998 case files were retrieved, giving a file retrieval rate of 72.8%. Compared with booked mothers, unbooked mothers had more maternal complications and poorer perinatal outcomes. Caesarean section rate is significantly commoner among the unbooked patient (25.52% against 6.47%, P=0.000), antepartum eclampsia occur commonly in the unbooked patients (5.94% against 0.87% P=0.000),antepartum haemorrhage also occur significantly in the unbooked patients (2.95% against 0.47%, P=0.000). Postpartum haemorrhage is commoner in the booked patients (2.73% against 1.07% P=0.000).Low birth weight is commoner among the babies of the unbooked patient (21.51% against 7.22%, P=0.000), low Apgar scores is higher among babies of the unbooked patient (17.17% against 4.29%, P=0.000).There was no statistical difference in the occurrence of stillbirth between booked and unbooked patients(15.13% against 2.56% P=0.133). Conclusions: There is a significantly higher maternal and perinatal complication in the unbooked women than the booked. There is also a positive correlation between unbooked mothers and an increased risk of maternal and foetal adverse outcomes and that parity, distance and maternal age affect these outcomes.