Maternal complication prevention: evidence from a case-control study in southwest Nigeria

Abstract

BackgroundThe importance of strengthening maternal health services as a preventive intervention for morbidities and complications during pregnancy and delivery in developing countries cannot be over-emphasised, since use of prenatal health services improves maternal health outcomes.AimThis study investigated differences in risk factors for maternal complications in booked and unbooked pregnant women in Nigeria, and provided evidence for their prevention.SettingThe study was carried out in a postnatal ward in a secondary health facility.MethodsThis was a case-control study involving booked and unbooked pregnant women who had delivered. Consecutive enrolment of all unbooked pregnant women (cases) was done, and one booked pregnant woman (control) was enrolled and matched for age with each of these. Both groups were interviewed using a questionnaire, whilst records of delivery were extracted from the hospital files. Findings were subjected to logistical regression at a significance level of p < 0.05.ResultsBooked women had a lower median length of labour (10 hours) compared to unbooked women (13 hours). More women in the booked control group (139; 35.1%) than in the unbooked case group (96; 23.6%) reported at least one type of morbidity during the index pregnancy (p = 0.0004). Booking status was associated with a likelihood of spontaneous vaginal delivery. Young maternal age, low education, rural residence and low socio-economic status were associated with less likelihood of using prenatal services. Young maternal age, low education and intervention in the delivery were associated with a likelihood of experiencing a complication of delivery.ConclusionStrengthening antenatal and secondary healthcare services as short- and medium-term measures might be cost-effective as a preventive strategy in complications of pregnancy, whilst socio-economic dimensions of health are accorded priority in the long term.

Experiences of Midwives for Caring Unbooked Pregnant Mothers in a Maternity Unit at a District Hospital in the Eastern Cape Province

“…It also revealed that caring for these types of patients require both enough basic equipment and human resources. This would minimise some complications [26].…”

“…A study conducted in sub-Saharan Africa on reasons of women not using antenatal care service found that the high maternal mortalities are associated with unbooked pregnant mothers [9]. These circumstances affect middle and Low…”