Adverse Maternal Outcomes among Women Delivered at Public Hospitals in Eastern Ethiopia: A Cross-Sectional Study

Masresha Leta ^1* Abera Kenay Tura ² Haymanot Mezmur ² Kasiye Shiferaw Gemechu ² Nega Assefa ²

• ¹ Harar Health Science College (HHSC), Harar, Ethiopia
• ² School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Dire Dawa, Ethiopia

Background: An adverse maternal outcome such as anaemia, postpartum haemorrhage, and postpartum eclampsia causes a significant risk to the women. While studies on the burden of adverse maternal outcomes have been conducted in various countries, including Ethiopia, many predictors were not fully explored beyond obstetric factors. This study aimed to determine the magnitude and factors associated with adverse maternal outcomes .Methods: A hospital-based cross-sectional study was conducted among 2,608 randomly selected women who gave birth in six public hospitals in Eastern Ethiopia from November 2023 to March 2024. Data were collected through interview face-to-face to a couple of clinical chart reviews. Factors associated with adverse maternal outcomes were identified using bivariable and multivariable robust Poisson regression analyses. Adjusted relative risks (ARR) with 95% confidence intervals (CIs) were used to report the strength of the association. Those variables with a p-value of < 0.05 were considered statistically significant.The magnitude of adverse maternal outcome was 15.68% (95% CI: 14.70-16.66%).A poor wealth index classification was associated with a significantly higher risk of adverse maternal outcomesThe poor wealth index classification (ARR=4.41 (95% CI; 3.46, 5.62), having danger signs at admission (ARR= 1.86 (95% CI; 1.18, 2.91), alcohol use during pregnancy (ARR= 1.86 (95% CI; 1.32-2.62), duration of labour > 24 hours (ARR= 1.69 (95% CI; 1.00-2.85), and maternal age greater than 35 (ARR= 1.39 (95% CI; 1.03-1.86) increased the risk of the adverse maternal outcome. Whereas, folic acid intake during pregnancy (ARR= 0.47 (95% CI; 0.38-0.57), having partner support (ARR= 0.70 (95% CI; 0.59-0.83), and spontaneous vaginal delivery(ARR= 0.58 (95% CI; 0.49-0.68) reduces the risk of adverse maternal outcomes.One in six women who gave birth in eastern Ethiopia experienced adverse maternal outcomes and was determined to be moderate when compared to the WHO projections for lower-and middle-income countries and this suggests better than the higher averages reported by WHO. Targeted interventions programes such as target education and empowerment program as well as strengthening of community health worker program helps to address socio-economic disparities and improve early detection and management of danger signs during pregnancy would helpwhich aid in averting the occurrence of the problems.