ABSTRACT
Objectives: High prevalence of poor pregnancy (miscarriage) and birth (stillbirth) outcomes has been reported among poor women in Ethiopia. This study evaluated the underlining associated factors. Methods: The study used a cross-sectional design to interview 5192 mothers of children under 5 years of age, who were living in 60 villages, across 60 sub-districts in 6 zones of the Amhara Region of Ethiopia. Socio-demographic, obstetric, and birth information were collected using standardised questionnaires and household salts were tested with rapid test kits. The study protocol received ethical approval from McGill University, Ethiopian Health and Nutrition Research Institute, and the Ethiopian National Research Ethics Review Committee. Results: Households were mainly individual dwellings (83.4%) with agricultural land (90.9%) and rearing livestock (94.1%). Majority of household heads and mothers were illiterate (63.7% and 81.2%, respectively). Sanitation (61.0% scored ≤ 1 out of 3), assets (84.1% scored ≤5 out of 10) and use of iodised salt (6.4%) were very poor and goiter presence in the family was high (41.7%). Prevalence of miscarriage was 95.4 per 1000 pregnancies and stillbirth was 22.7 per 1000 live births. The use of non-iodised salt was associated with miscarriage (r=0.06; p<0.05). Self-reported anaemia, vomiting, and urinary tract infection during pregnancy were common (37.2%, 26.08%, and 19.47% respectively) and were associated with prevalence of miscarriage and stillbirth(r=0.04 to 0.06; p<0.05). Conclusions: Poor pregnancy and birth outcomes occur frequently in rural Ethiopia and are associated with indicators of inadequate dietary intakes of micronutrients.