Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia.
<h4>Background</h4>Obstetric hemorrhage is defined as active bleeding of more than 500 ml in vaginal delivery or 1000ml following cesarean delivery. It is the leading cause of maternal death, which contributes to up to 50% of maternal deaths in Ethiopia. This study aims to assess the rel...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0274866 |
| _version_ | 1811229166400438272 |
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| author | Neamin Tesfay Rozina Tariku Alemu Zenebe Haymanot Firde Fitsum Woldeyohannes |
| author_facet | Neamin Tesfay Rozina Tariku Alemu Zenebe Haymanot Firde Fitsum Woldeyohannes |
| author_sort | Neamin Tesfay |
| collection | DOAJ |
| description | <h4>Background</h4>Obstetric hemorrhage is defined as active bleeding of more than 500 ml in vaginal delivery or 1000ml following cesarean delivery. It is the leading cause of maternal death, which contributes to up to 50% of maternal deaths in Ethiopia. This study aims to assess the relationships between adverse maternal health exposure (personal and medical factors) and delay in health care (hesitancy in opting to seek care, lag in reaching a health facility, and wait in receiving health care at the facility) and adverse outcomes of obstetric hemorrhage among reviewed maternal deaths in Ethiopia.<h4>Methods</h4>This study utilizes 4530 reported maternal death surveillance data obtained from Ethiopian maternal death surveillance and response (MDSR) system between 2013 to 2020. Latent class analysis was applied to identify underlying patterns of adverse maternal health exposures. Furthermore, the associations between latent classes and adverse outcomes of obstetric hemorrhage were analyzed using multilevel logistics regression model adjusted for clustering within reporting provinces.<h4>Results</h4>Nearly 56% of the reviewed maternal deaths were due to the adverse outcome of obstetric hemorrhage, among which nearly 75% died during the postpartum period. The study identified six separate sub-groups of women based on their vulnerability to adverse maternal health conditions. The six subgroups identified by this study are 1) women who travelled for a long duration to reach a health care provider, 2) those who had no access to a health facility (HF) within a 5Km radius, 3) those who failed to decide to go to a health facility: 4) those with multiparity,5) those who were injured during delivery with history of coagulopathy, and 6) those who got injured during delivery and failed to decide to go to a health facility. Women in the class of grand multipara have demonstrated the highest risk of death due to the adverse outcomes of obstetric hemorrhage (β = 1.54, SE = 0.09, p<0.0001).<h4>Conclusions</h4>The study has attempted to identify women that are at a higher risk for the adverse outcomes of obstetric hemorrhage. Henceforth, targeted intervention should be taken on women of reproductive age group, and those identified as at a higher risk, to reduce the high rate of maternal death due to obstetric hemorrhage. |
| first_indexed | 2024-04-12T10:10:22Z |
| format | Article |
| id | doaj.art-ca5a62e7671341088810553e9f37a83b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-12T10:10:22Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ca5a62e7671341088810553e9f37a83b2022-12-22T03:37:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01179e027486610.1371/journal.pone.0274866Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia.Neamin TesfayRozina TarikuAlemu ZenebeHaymanot FirdeFitsum Woldeyohannes<h4>Background</h4>Obstetric hemorrhage is defined as active bleeding of more than 500 ml in vaginal delivery or 1000ml following cesarean delivery. It is the leading cause of maternal death, which contributes to up to 50% of maternal deaths in Ethiopia. This study aims to assess the relationships between adverse maternal health exposure (personal and medical factors) and delay in health care (hesitancy in opting to seek care, lag in reaching a health facility, and wait in receiving health care at the facility) and adverse outcomes of obstetric hemorrhage among reviewed maternal deaths in Ethiopia.<h4>Methods</h4>This study utilizes 4530 reported maternal death surveillance data obtained from Ethiopian maternal death surveillance and response (MDSR) system between 2013 to 2020. Latent class analysis was applied to identify underlying patterns of adverse maternal health exposures. Furthermore, the associations between latent classes and adverse outcomes of obstetric hemorrhage were analyzed using multilevel logistics regression model adjusted for clustering within reporting provinces.<h4>Results</h4>Nearly 56% of the reviewed maternal deaths were due to the adverse outcome of obstetric hemorrhage, among which nearly 75% died during the postpartum period. The study identified six separate sub-groups of women based on their vulnerability to adverse maternal health conditions. The six subgroups identified by this study are 1) women who travelled for a long duration to reach a health care provider, 2) those who had no access to a health facility (HF) within a 5Km radius, 3) those who failed to decide to go to a health facility: 4) those with multiparity,5) those who were injured during delivery with history of coagulopathy, and 6) those who got injured during delivery and failed to decide to go to a health facility. Women in the class of grand multipara have demonstrated the highest risk of death due to the adverse outcomes of obstetric hemorrhage (β = 1.54, SE = 0.09, p<0.0001).<h4>Conclusions</h4>The study has attempted to identify women that are at a higher risk for the adverse outcomes of obstetric hemorrhage. Henceforth, targeted intervention should be taken on women of reproductive age group, and those identified as at a higher risk, to reduce the high rate of maternal death due to obstetric hemorrhage.https://doi.org/10.1371/journal.pone.0274866 |
| spellingShingle | Neamin Tesfay Rozina Tariku Alemu Zenebe Haymanot Firde Fitsum Woldeyohannes Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia. PLoS ONE |
| title | Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia. |
| title_full | Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia. |
| title_fullStr | Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia. |
| title_full_unstemmed | Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia. |
| title_short | Target areas to reduce the burden of maternal death due to obstetric hemorrhage in Ethiopia. |
| title_sort | target areas to reduce the burden of maternal death due to obstetric hemorrhage in ethiopia |
| url | https://doi.org/10.1371/journal.pone.0274866 |
| work_keys_str_mv | AT neamintesfay targetareastoreducetheburdenofmaternaldeathduetoobstetrichemorrhageinethiopia AT rozinatariku targetareastoreducetheburdenofmaternaldeathduetoobstetrichemorrhageinethiopia AT alemuzenebe targetareastoreducetheburdenofmaternaldeathduetoobstetrichemorrhageinethiopia AT haymanotfirde targetareastoreducetheburdenofmaternaldeathduetoobstetrichemorrhageinethiopia AT fitsumwoldeyohannes targetareastoreducetheburdenofmaternaldeathduetoobstetrichemorrhageinethiopia |