| dc.description.abstract |
Background:
Pregnancy after 41 weeks of gestation is at risk of increased perinatal mortality and morbidity.
There are only descriptive studies on outcome of post-term pregnancy in Ethiopia. No study was
done to compare the study groups in our setting.
Methods:
A retrospective cohort study in low-risk pregnant women on selected maternity centers
was conducted at MSI Ethiopia Reproductive choices MCH centers and Abebech Gobena
Maternity Hospital in Addis Ababa. The primary outcome of the study was composite adverse
perinatal outcomes (Perinatal death, APGAR score at 1st min <4, APGAR
score <7 at five minutes and admission to NICU for >24 hours) and Cesarean section
rate as secondary outcome. Comparisons of composite adverse birth outcomes among the two
groups were done using the Chi-square test. A multivariable logistic regression model was used
to assess associations between the two groups with each pregnancy outcome, adjusted for the
potential confounding factors. Stata 14.0 software was used for data cleaning and analysis.
Result:
A total of 1,601 study subjects were included in the study with 553 induced (the exposed group)
and 1,048 managed expectantly (the non-exposed group). The overall rate of composite adverse
birth outcomes was 9/553(1.63%) in the exposed group and the non-exposed group
118/1,048(10.31%), with RR =7.79 (95% CI: 3.39 to 17.90; P = 0.001). Significantly higher
Instrumental delivery rates were observed in the exposed group compared to the non-exposed
group with RR=14.6(P=0.001) but the cesarean section rate was similar in both groups with
RR=0.97 (P = 0.001). Postpartum hemorrhage occurred more in the exposed group compared
to the non-exposed group with RR=1.6(P=0.015).
Conclusion & recommendation:
Early intervention significantly reduced adverse perinatal outcomes without an increased rate of
cesarean section. The national guideline needs to consider offering IOL starting from 41
completed weeks of gestational age. |
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