Prevalence of adverse neonatal outcomes and associated factors among births through instrumental assisted vaginal delivery at the University of Gondar specialized teaching hospital, Northwest Ethiopia, 2019-2021

Abstract

Abstract Background: - Globally, it is estimated that about 2%-23% of deliveries are OVD. The incidence of OVD has significant variation across countries. In Ethiopia it accounts from 7%-16.9% of births in different study. In developing countries like Ethiopia, newborns develop different degree of morbidity due to OVD. Up on my observation during my clinical exposure I have many encounters of adverse neonatal outcome. However, as to our search of literatures, there is limited evidence on the prevalence of adverse neonatal outcomes and its associated factors among OVD. Objective: - To assess Adverse neonatal outcome and associated factors of OVD women attending instrumental delivery at the university of Gondar Comprehensive Specialized Hospital (UOGCSH) North west Ethiopia,2021. Methods: - An Institutional based cross-sectional study was conducted at UOGCSH in labor and delivery ward from September 1, 2019 to August 30, 2021 with sample size of 303. Semistructured

questioner was utilized. Epi-Data version 4.6 statistical software was used for data entry and exported to SPSS version 25 statistical software for data management analysis. Chisquare

assumption was checked to assess variables eligibility for the logistic regression. To identify the associated factors, binary logistic regression model was fitted and variables with pvalue<0.2

were considered for the multivariable binary logistic regression analysis. In the multivariable binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% CI were reported to declare the statistical significance and strength of association between the adverse birth outcomes and the independent variables. Result: - A total of 303 births delivered through operative vaginal delivery were included. The mean age of mothers were 25.19 years (�7years). The proportion of adverse neonatal outcomes among neonates delivered through OVD was 23.1% (95%CI: (18.68%, 28.21%). In the multivariable binary logistic regression analysis, presence MSAF (AOR=6.22, 95%CI: (3.09,12.55) and primigravidity (AOR=2.49, 95%CI: (1.13,5.16) were significantly associated with adverse neonatal outcomes. Conclusion and recommendation: - The commonest indication for OVD is prolonged SSOL (71%). Among mothers who gave birth by OVD, 23.1% unfavorable neonatal outcome. Presence of MSAF and primigravidity are factors affecting neonatal outcome. 6

Keywords: Adverse neonatal outcomes, UOGCSH, instrumental delivery, operative vaginal delivery.