Knowledge and understanding of obstetric danger signs among pregnant women attending the antenatal clinic at the National Referral Hospital in Thimphu, Bhutan: a cross-sectional study

Abstract

Background: The third Sustainable Development Goal for 2030 development agenda aims to reduce maternal and newborn deaths. Pregnant women’s understanding of danger signs is an important factor in seeking timely care during emergencies. We assessed knowledge of obstetric danger signs using both recall and understanding of appropriate action required during obstetric emergencies. Methods: This was a cross-sectional study among pregnant women attending antenatal clinic at Bhutan’s largest hospital in Thimphu. Recall was assessed against seven obstetric danger signs outlined in the Mother and Child Health Handbook (7 points). Understanding of danger signs was tested using 13 multiple choice questions (13 points). Knowledge was scored out of 20 points and reported as “good” (≥80%), “satisfactory” (60 – 79%) and “poor” (<60%). Correlation between participant characteristics and knowledge score as well as number of danger signs recalled was tested using Pearson’s correlation coefficient. Association between knowledge score and participant characteristics were tested using t-tests (and Kruskal-Wallis test) for numeric variables. Socio-demographic and clinical characteristics associated with the level of knowledge (“good” versus “satisfactory and poor” combined) were assessed with odds ratios (OR) using a log-binomial regression model. All results with p < 0.05 were considered significant.Results: Four hundred and twenty-two women responded to the survey (response rate = 96.0%). Mean (±SD) knowledge score was 12 (±2.5). Twenty women (4.7%) had “good knowledge”, 245 (58.1%) had “satisfactory knowledge” and 157 (37.2%) had “poor knowledge”. The median number of danger signs recalled was 2 (IQR 1, 3) while 68 (20.3%) women could not recall any danger signs. Most women were knowledgeable about pre-labour rupture of membranes (96.0%) while very few women were knowledgeable about spotting during pregnancy (19.9%). Both knowledge score and number of danger signs recalled had significant correlation with the period of gestation. Women with previous surgery on the reproductive tract had higher odds of having good level of knowledge. Conclusions: Most pregnant women had satisfactory knowledge score with poor explicit recall of danger signs. However, women recognized obstetric emergencies and identified the appropriate action warranted.

Knowledge of Birth Preparedness and Complication Readiness and Associated Factors among Pregnant Women in Ibadan, Nigeria

“…This was also supported by Ijang et al who reported that knowledge of Obstetric danger signs was associated with the practice of BPCR among pregnant women [10]. More importantly, good knowledge of obstetric dangers signs in pregnancy has been indicated as one of the factors promoting complication readiness as well as receiving timely emergency obstetric care [21]. Therefore, many pregnant women will still benefit from awareness programs and other interventions to raise awareness of these obstetric danger signs among pregnant women.…”

Factores asociados al nivel de conocimiento y actitudes sobre signos y síntomas de alarma en gestantes atendidas por teleconsulta en el Instituto Nacional Materno Perinatal durante el año 2020

“…Según el estudio de Pembe A et al 18 , ellos también determinaron que el estado civil no tiene asociación, resultado que difiere de nuestro estudio; pero el nivel educativo sí difiere, pues ellos refieren que a mayor nivel escolar mayor conocimiento y por ende una mejor actitud sobre signos y síntomas de alarma. Ambas variables se consideran estadísticamente significativas en los estudios de Nebiyu Maseresha et al 19 y Tamang ST et al 20 , lo cual difiere parcialmente a los datos encontrados en nuestro estudio.…”

“…Posteriormente, se realizó el mismo análisis con la variable nivel de conocimiento, encontrándose una asociación estadísticamente significativa con las variables estado civil (RP 0,15, IC95% 1,09-1,20, p<0,001) y paciente añosa (RP 0,96, IC95% 0,89-1,04, p<0,001). Similares resultados vemos en Amenu et al 15 y Tamang ST et al 20 donde la variable presentar pareja se convierte en una asociación favorable para un alto nivel de conocimiento.…”