Determinants of adverse pregnancy outcomes among pregnant women attending antenatal care in public health facilities at Nyando sub-county, Kisumu, Kenya

Abstract

Globally, more than half a million women die in childbirth. Sub-Saharan Africa accounts for nearly 66% (196,000) of the global maternal deaths. In Kenya, the maternal mortality ratio stands at 355 deaths per 100,000 live births. In Kisumu County maternal mortality rate stands at 495 per 100,000 live births per year. Nyando Sub-County has the second-worst record of adverse pregnancy outcomes. This study intends to establish the determinants of these adverse pregnancy outcomes. Adverse pregnancy outcomes are those pregnancy outcomes other than normal live birth including socio-demographic factors such as the age of the mother, educational level, level of income, and place of residence. Obstetric factors such as the previous history of adverse birth outcome, antepartum hemorrhage, and history of abortion, gestational age, pregnancy interval, obstetric complications, and the number of parities associated with adverse birth outcome. And cultural factors such as Food Taboos, smoking, and Traditional Birth Attendance (TBAs). The broad objective of this study is to assess the determinants of adverse pregnancy outcomes among women attending an antenatal care clinic at public health facilities in Nyando Sub-County Kisumu County, Kenya. Specifically, the study determines the Obstetric factors that influence adverse pregnancy outcomes among women; assess the cultural factors that influence adverse pregnancy outcomes; assess the influence of socio-economic status on adverse pregnancy outcomes: establish the influence of ANC visits on adverse pregnancy outcomes among women attending antenatal care clinic in public health facilities in Nyando sub-county Kisumu County, Kenya. There was an analytical cross-sectional study design conducted in Nyando sub-County. Randomly generated numbers facilitated the selection procedure using Microsoft Excel and were estimated to be 301 participants according to the calculated sample size. Selection based on the lineup in the cue and with special consideration for only those who visited ANC twice or more. An interview was administered to pregnant women who have come for an ANC visit. This study shows 49.7% of adverse pregnancy outcomes. The chi-square test was used to test for significance and risk associated with a determinant of adverse pregnancy outcome. Chi-square analysis showed that<15 years ofage was associated with adverse pregnancy outcomes (p=0.001) (Table1). Logistic regression analysis was used to establish the influence of the ANC clinic on adverse pregnancy outcomes (Using 3 visits as the reference group, the study did not find any association with the number of visits OR (0.36-1.26), p=0.314). Through this research, the community will further realize the important of promoting hospital visits, especially ANC services for para >5 pregnant women to avoid adverse pregnancy outcomes since this finding reveal an association with adverse pregnancy outcomes in this particular group. Results will be disseminated to various health facilities where this research was conducted, Nyando Sub-County Kisumu, and to Maseno university school of graduate studies.