FACTORS ASSOCIATED WITH OBSTRUCTED LABOR AND ITS MATERNAL AND PERINATAL OUTCOMES AMONG MOTHERS WHO GAVE BIRTH AT WOLKITE UNIVERSITY SPECIALIZED HOSPITAL: UNMATCHED CASE-CONTROL STUDY, WOLKITE, ETHIOPIA

Abstract

Background: Global maternal mortality due to obstructed labor is responsible for 9% of all maternal deaths. About half of the maternal deaths occurred in sub-Saharan Africa alone and one third took place in South Asia. Obstructed labor contributes 13% of maternal death in Ethiopia. Women who experienced obstructed labor for prolonged time can be complicated with fistula, serious social issues of divorce, separation from religious exercises, detachment from their families which can worsen poverty and malnutrition. Objective: To assess factors associated with obstructed labor and its maternal and perinatal outcomes among mothers who gave birth in WKUSH from January, 2022 to December, 2024 Methodology: Unmatched case - control study design was employed among cases and controls who delivered in WKUSH from January, 2022 to December 2024. Total sample size calculated to be 176, 59 were cases and 117 were control. Cases of obstructed labor were selected by simple random sampling and convenience sampling was employed to enroll the control group. Bivariate analysis between dependent and independent variables was performed. Variables with a p-value of < 0.05 were used as statistically significant factors and adjusted odds ratio with 95% confidence interval was used to measure strength of association. Results: A total of 176 study subject, 59 cases and 117 control were enrolled the study. After performing multivariate logistic regression, four variables (distance from WKUSH, nulliparity, partograph utilization and place of labor follow up at health center) were the significant predictors of obstructed labor. Stillbirth, birth asphyxia, postpartum hemorrhage, obstetric fistula, SSI, longer hospital stay and maternal death were the major adverse perinatal outcome identified among cases. Conclusions: Obstructed labor was associated with increased maternal and newborn morbidity and mortality. Stillbirth, birth asphyxia, postpartum hemorrhage, SSI, longer hospital stay, obstetric fistula and maternal death were the common adverse outcomes of obstructed labor. Increasing accessibility of comprehensive obstetric care to the community, improving partograph utilization, and optimal creation of awareness in the community for birth preparedness and complication readiness may prevent occurrence of obstructed labor.