PREVALENCE AND FACTORS ASSOCIATED WITH ADVERSE NEONATAL OUTCOMES AMONG CESAREAN DELIVERIES AT PUBLIC HOSPITALS IN HAWASSA CITY, SIDAMA REGION, ETHIOPIA

Abstract

Background: Cesarean deliveries are linked to higher risks of adverse neonatal outcomes compared to spontaneous vaginal births. In Ethiopia, comprehensive data on these outcomes and associated factors is lacking. Understanding these issues in hospitals is crucial for improving maternal and neonatal care. Objective: This study aimed to assess prevalence and factors associated with adverse neonatal outcomes among cesarean deliveries at public hospitals in Hawassa city, Sidama region, Ethiopia. Method and material: a facility based retrospective cross-sectional study was conducted at two public hospitals in Hawassa city from April 1 to 30, 2024, analyzing 522 hospital medical records of mothers who delivered by CS from Jan 2023 to Aug 2024. Data were collected using a structured data extraction checklist via kobocollect 4.0, and Simple random sampling technique was employed to select study participants. Data were analyzed using SPSS version 27, employing Binary and Multiple Logistic regressions to identify factors associated with adverse neonatal outcomes. Statistical significance was stated at p-value<0.05, with adjusted odds ratio (AOR) and 95% confidence interval (CI) reported. Result: nearly one-third of newborns delivered through cesarean section developed adverse outcome. Women who had preeclampsia and abruptio-placenta were 2.9 (AOR: 2.9; 95% CI; 1.104, 3.38 and 3.3 times (AOR: 3.3; 95% CI; 1.36, 8.21) more likely to develop an adverse neonatal outcomes compared with those women who did not have the condition respectively. Similarly women who delivered by midline cesarean section were 2.9 times (AOR: 2.9; 95% CI; 1.125, 7.4) more likely to develop adverse neonatal outcomes compared with those women who delivered by lower transverse cesarean section. Women who referred from other facility were 2.8 times (AOR: 2.8; 95% CI; 1.82, 4.4) more likely to develop adverse neonatal outcomes compared with those women who were not referred. Conclusion: prevalence of adverse neonatal outcomes was high in the study area. Preeclampsia, abruptio-placenta, being referred from other health facility, and delivery via midline cesarean section were factors associated with adverse neonatal outcomes. Timely intervention for high-risk pregnancies could help reduce adverse neonatal outcomes.