Pattern and determinants of obstetric complications among women delivered at Yusuf Dan-Tsoho Memorial Hospital Tudunwada, Kaduna

Abstract

Despite global decrease in maternal mortality ratio from 1990 to 2010, annually approximately 9.5 million women around the world suffer from pregnancy-related complications, and over 300,000 die. Majority are in sub-Saharan Africa. A Nigerian woman is 500 times more likely to die in child birth than her European counterpart. There is a marked variation in the maternal mortality ratio between geo-political zones of Nigeria with more in the Northern zones compared with the southern zones. Kaduna State has unacceptably high maternal mortality rates and burden profile.

The study aimed to contribute towards improving the outcome of pregnancy by determining the pattern and determinants of obstetric complications among women who delivered at Yusuf Dan-Tsoho Memorial Hospital (YDMH), Tudun-Wada, Kaduna.

Methods: It is a cross-sectional study conducted in the Obstetrics and Gynaecology Department of Yusuf Dantsoho Memorial General Hospital, Tudun-Wada, Kaduna from February to April 2014. Two hundred and six women who delivered during the study period irrespective of their booking status and consented to participate in the study were recruited consecutively. A questionnaire containing
sections on socio-demographic characteristics, family characteristics, pattern of obstetric complications and factors influencing antenatal care service utilization was administered. Relevant physical examination and laboratory investigations were also carried out.

Results: Majority of the participants were Hausas (74.8%), Muslims (94.7%), married (99.0%), unemployed (45.1%) and within the age group of 20-29 years (58.7%). Most were from monogamous family set up (62.1%) and had secondary education (44.2%). Twenty five percent of the participants were unbooked, 29% booked elsewhere and 46% were booked. One hundred and thirty seven (66.5%) of the study participants had one or more obstetric complications. Prolonged/obstructed labour was the commonest (27.7%), followed by post-partum haemorrhage (23.4%). Pre-eclamsia and eclampsia accounted for 18.2% and sepsis 5.8%. Post partum haemorrhage was significantly associated with the age group of 20-29 years and Pre-eclampsia/eclampsia was significantly associated with illiteracy. The number of antenatal care visits also significantly predicted the likelihood of obstetric complications. Binomial logistic regression analysis predicted that the more the number of antenatal care visits the less likely the occurrence of obstetric complications, with 4 or more visits reducing obstetric complications 14 times.

Conclusion and recommendations: Maternal morbidity is still high in the study area. This was significantly associated with inadequate utilization of antenatal care services. Booking status did not significantly influence obstetric complications. Level of education and women in the middle childbearing age (20-29) were found to significantly affect some of the obstetric complications. It is therefore recommended that maternal health education on the importance of utilization of maternal health care services using the WHO recommendation, female education and empowerment should be emphasized.