In this study, we assessed the prevalence and associated factors of adverse birth outcomes (stillbirth, preterm birth and low birth weight) among women who gave birth at selected public hospitals in Eastern Ethiopia. The overall prevalence of adverse birth outcomes among the study participants was 13.7%. This finding is relatively similar with studies finding from Kembata Tembaro zone(13.9%) (15) and Hawassa (18.3%)(16), but lower than that of Gondar (23%)(17), Hossana town (24.5%) (18) and Wollo zone (31.8%)(19). This variation may be due to the difference in the study setting, socio-cultural status, maternal and newborn health care services and various interventions undertaken between these study times.
In this study we found that 7.2% of deliveries were delivered as low birth weight babies. This finding is consistent with studies finding in Butajira (8.9%)(18), Gondar (11.2%)(17), and Hawassa (11.6%)(16). However, lower than the study done in Wollo (19.5%)(19). The possible explanation for this discrepancy may be attributable to socio-economic variations and the difference in the quality of maternal health service. Also, the variation of nutritional and cultural practices may contribute to the observed differences.
In our study 6.7% of deliveries were stillbirth. This finding is in line with that of Gondar (7.1%)(17) and Wollo (7.8%)(19) but higher than that of Hawassa (2.7%)(16), Kembata Tembaro (3.3%)(15) and Butajira (3.5%)(18). The discrepancies may be due to methodological and population variation on top of the socio-economic and set up differences.
In this study the prevalence of preterm birth was 5%. This finding is consistent with that of Hawassa (3.6%)(16) and Butajira (6.4%)(18) but lower than that of Wollo (13.2%)(19) and Gondar (14.3%)(17). The difference may be due to variation in populations and study setting and quality of maternal healthcare service.
The findings from the multiple logistic regression analysis revealed that hypertension, history of adverse birth outcomes, multiple pregnancy, and spontaneous vaginal delivery were significantly associated with adverse birth outcomes. This finding was almost found to be a universal fact and has been revealed in many studies (16, 17, 20).
This study showed that women who had diagnosed hypertension were statistically significant with adverse birth outcomes. This finding is in line with studies finding from china, Tanzania and Ethiopia (17, 20–22). It can be justified by uteroplacental hypo-perfusion secondary to vasoconstriction which results in diminished blood supply to the fetus causing adverse fetal/birth outcome.
In our finding women with a previous history of adverse birth outcomes were significantly associated with adverse birth outcomes. This is in line with the report from other studies from china, Tanzania and Ethiopia (16, 17, 21, 22). This might be due to most bad obstetrics histories are recurrent and more likely to result in adverse birth outcome in subsequent pregnancies.
The study finding showed that women with multiple pregnancies were significantly associated with adverse birth outcomes. This finding is similar to other studies finding from Ethiopia(20, 23). This might be due to chorionicity and amniocity of placentation which is associated with fetal mortality and morbidity in monochorionic and mono amniotic twins. There was also a complication unique to twin pregnancy which is twin transfusion syndrome, discordant twin, conjoined twin, vanishing effect which increases the risk of adverse birth outcomes. The risk of anemia and pregnancy-related complications also increase in multiple pregnancies hence more likely to result in adverse birth outcomes.
The study also revealed that the odds of adverse birth outcome is less by 11% among women who gave birth through spontaneous vaginal delivery than those women who delivered by cesearean section. This finding is in contrast with other studies findings from china and WHO Multi-country Surveys(24, 25). The difference may be due to study setting as those two studies were large and were conducted at better health care set up were ceaseran delivery performed on elective basis without indication than the current study. Finally, as limitations the findings of this study were based on self-report, as it was not possible to validate claims made by respondents in the course of questionnaire administration.