Incidence and Predictors of Dystocia of Active First Stage of Labor at Debremarkos Comprehensive Specialized Hospital Amhara, North West Ethiopia, 2022/2023

Abstract

Background Dystocia of active first stage of labor `has a notable contribution to maternal and fetal and / or neonatal morbidity and mortality. It is a main reason for the increasing rate of cesarean delivery in the world. Majorities of the determinants of dystocia in active first stage of labor could be modifiable, and may vary across the settings and over time trend. So, contextual scientific studies in this regard are imperative for evidence-based interventions. However, there was a dearth of evidence about extent and contributing factors of dystocia of active first stage of labor in Ethiopia. Objective This study aimed to assess the incidence and predictors of dystocia of active first stage of labor among laboring women at debremarkos comprehensive specialized hospital Amhara, northwest Ethiopia, 2022/23. Methods Prospective cohort study was conducted among 656 laboring women from October 20 to January 4/2023. The study participants were selected by using a systematic random sampling technique. Data were collected through observation, interview using a pretested structured questionnaire, and document review. Both descriptive and inferential analyses were carried out. Binary Logistic Regression was fitted and the level of significance was declared based on Adjusted Odds Ratio (AOR) with its 95% Confidence Interval (CI) and p-value of ≤ 0.05. Result The overall incidence of dystocia of AFSOL was 35.3%( 95%CI: 31.9, 39.2). Induction of labor (AOR: 2.5; 95%CI: 1.23. 5.42), admitting of laboring mother with cervical dilation of < 4cm (AOR: 2.9; 95%CI: 1.72, 4.93), poor health care provider support (AOR: 7.5; 95%CI: 4.18, 13.67), and caffeine intake > 200mg (≥ 3cup of coffee) (AOR: 3.7; 95%CI: 1.80, 7.74), Drinking of linseed (AOR: 0.28; 95%CI: .14, .55), ANC follow up (AOR: .24; 95%CI: .09, .63), and ambulation during AFSOL (AOR: 0.31; 95%CI: .13, .69) were predictors of dystocia of active 1st stage of labor. Conclusion The incidence of DAFSOL was high. Having ANC follow up, eating/drinking of linseed at the onset of labor pain and ambulating during active first stage of labor, drinking of three or more cup of coffee per day during pregnancy, induction of labor, poor health care provider support during AFSOL and admitting of the laboring mothers while cervical dilation < 4cm were predictors of DAFSOL. Adopting WHO labor care guide and encouraging health care providers to practice evidence based practice regarding the management of active 1st stage of labor and good patient handling during the laboring process is recommended to minimize the diagnosis of DAFSOL and its unnecessary interventions.