Neonatal outcomes of preterm neonates and its predictors in Ethiopian public hospitals: Multicenter prospective follow-up study.

Introduction: Preterm birth remains the most significant clinical and public health encounter. Preterm infant outcomes pose key evidence for clinicians and policymakers and are extensively used to set clinical and policy verdicts to improve services. It is necessary to conduct the outcomes of neonates frequently, as it varies from place to place and even from time to time in a similar place. There is limited literature in Ethiopia about preterm neonates' outcomes and their predictors. Objective: This study aimed to assess the neonatal outcomes of preterm neonates and their predictors in South Gondar zone public hospitals, Northwest Ethiopia, 2021. Methods: A prospective observational study was employed on 462 preterm neonates in South Gondar Zone Public Hospitals. The data were entered into Epidata 4.6 and analyzed using STATA version 16/MP software. A parametric log-normal survival model was used to identify possible predictors for preterm neonate death. Statistical significance was declared at a P-value less than 0.05. Result: The overall preterm survival rate was 71.1% (95% CI: 66.7, 75.1). Thirty-six percent of preterm neonates were diagnosed with sepsis. One-fourth of the neonates had respiratory distress syndrome. Gestational age greater than 34 weeks (ß = 1.04; 95% CI: 0.53, 1.56), respiratory distress syndrome (ß = 0.85; 95% CI: 0.49, 1.22), body mass index (ß = -1.34; 95% CI: -1.87, -0.80), non-union marital status (ß = -0.71; 95% CI: -1.34, -0.09), multiple pregnancies (ß = -0.66; 95% CI: -0.99-0.32), multiparous (ß = 0.35; 95% CI: 0.01, 0.69), hypothermia (ß = -1.19; 95% CI: -1.76, -0.62), Kangaroo Mother Care (ß = -1.9; 95% CI: -2.34, -1.41) and non-cephalic presentation (ß = -1.23; 95% CI: -1.99,-0.46) were significant predictors. Conclusion: In this study, the preterm survival rate was low. Gestational age greater than 34 weeks, no respiratory distress syndrome, and multiparous mothers were positively associated with the survival of preterm neonates. Though, high pre-pregnancy maternal body mass index, non-union marital status of mothers, multiple pregnancies, hypothermia, Kangaroo mother care is not given, and non-cephalic presentation were negatively associated. A significant focus should be given to implementing WHO recommendations on preventing and caring for preterm births.

Mother-Infant Bonding and Its Associated Factors Among Mothers in the Postpartum Period, Northwest Ethiopia, 2021.

Background: The emotional bond that a mother senses to her infant is essential to their social, emotional, and cognitive development. Understanding the level of mother-infant bonding plays an imperative role in the excellence of care. However, in Ethiopia, there is a paucity of information about mother-infant bonding in the postpartum period. Objective: This study aimed to assess the level of mother-infant bonding and its associated factors among mothers in the postpartum period, Debre Tabor Town Northwest Ethiopia, 2021. Methods: A community-based cross-sectional study was conducted with 422 postpartum mothers. The postpartum Bonding Questionnaire was used to assess mother-infant bonding. The Edinburgh Postnatal Depression Scale was used to assess postnatal depression. The level of marital satisfaction was assessed by using Kansas marital satisfaction scale. Social support was assessed by Oslo social support scale. A simple random sampling technique was applied to select study participants. Simple and multiple linear regression were used to identify potential factors associated with the mother-infant bonding scale. A P-value of <0.05 was considered to declare statistical significance. Results: In this study, out of 420 postpartum mothers,53 (12.6%) had a risk for the quality of mother-infant bond difficulties between mother and an infant; 8.1% of mothers had a risk for rejection and pathological anger; 3.6% of mothers had a risk for infant-focused anxiety and 1.9% of mothers had risk for incipient abuse of an infant. Maternal depression status [adjusted ß coefficient (ß) = 2.31, 95% CI: (1.98, 2.64)], non-union marital status [ß = 15.58, 95% CI: (9.88, 21.27)], being government employee [ß = -5.68, 95% CI: (-9.71, -1.64)], having current pregnancy complication [ß = -7.28, 95% CI: (-12.27, -2.29)], being non-breastfeeding mother [ß = 7.66, 95% CI: (2.94, 12.38)], substance use history [ß = -6.55, 95% CI: (-12.80, -0.30)], and social support [ß = -2, 95% CI: (-2.49, -1.50)] were statistically significant factors for mother-infant bonding. Conclusion: Generally, a significant number of mothers had mother-infant bonding difficulties in the postpartum period. Preventing strategies for bonding difficulties focus on social support during pregnancy, screening postpartum mothers for postpartum depression, and special attention to substance users, non-union maternal status, and non-breastfeeding mothers.

Partograph utilization and associated factors among obstetric care givers in governmental health institutions of Jigjiga and Degehabur towns, Somali region, Ethiopia: A cross-sectional study.

BACKGROUND: Partograph is a simple, inexpensive & economical tool that provides a continuous graphical overview of labour and prevents prolonged and obstructed labor. The purpose of the study is to assess partograph utilization and associated factors among obstetric care givers in governmental health institutions of Jigjiga and Degehabur Towns, Somali Region, Ethiopia. METHODS: An institution based cross-sectional quantitative study was carried out among obstetric care givers who were working in governmental health institutions. Systematic random sampling with proportional to size allocation was used to recruit a total of 235 study participants. Self-administered questionnaire was used to collect data in this study. Three data collectors and one supervisor were recruited and trained to facilitate the data collection activities. Data were entered into Epi data software and exported into SPSS (23.0) for analysis. Descriptive statistics, bivariate and multivariate logistic regression were computed to determine proportions and significant association with partograph utilization among obstetric care givers. RESULT: Less than half of obstetric care givers, 41% (95%CI: 34.5-46.9) had good partograph utilization to monitor progress of labor. Being female [AOR = 2.36, 95%CI:(1.03-5.44)], availability of partograph [AOR = 4.633, 95%CI: (1.698-12.640)], having good knowledge [AOR = 6.90, 95%CI:(2.62-18.18)], receiving on job training [AOR = 15.46, 95%CI:(6.95-34.42)] and positive attitude towards partograph [AOR = 2.99, 95%CI:(1.25-7.14)] were significantly associated with partograph utilization. CONCLUSION: Partograph utilization in this study was low. Especial emphasizes and interventions should be given to periodic on job training that improve knowledge and attitude of obstetric care givers to increase partograph utilization.

Magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of eastern Ethiopia.

BACKGROUND: Use of substances like alcohol, tobacco and khat during pregnancy can bring miscarriage, prematurity, neurodevelopmental problems, sudden infant death syndrome and others. There are limited studies on the magnitude and associated factors of substance use among pregnant women in Eastern Ethiopia. Therefore, the aim of this study was to assess the magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of Easttern Ethiopia, 2019. METHOD: Hospital based cross-sectional study was employed on 510 pregnant women attending ANC at public hospitals of Eastern Ethiopia (Jigjiga, Dire Dawa and Harar towns). Data were collected from the study participants that were selected using systematic sampling method from each public hospital. The data were collected through interviewer administered structured questionnaire. Binary logistic regressions with 95% confidence interval were used to determine the degree of association between covariates and outcome variable. Multicollinearity between independent variables by using the standard error was checked. The goodness of fit was tested by Hosmer-Lemeshow statistic and Omnibus tests. RESULTS: Out of 526 participants, a total of 510 study participants were involved in this study thereby making a response rate of 96.9%. In this study, the magnitude of substance use among pregnant women attending ANC was 26.5% (95% CI: 22.7, 30.6%). Among the overall pregnant mothers, 100 (19.6%) chewed khat, 48 (9.4%) drank alcohol, 12 (2.4%) used tobacco products and 28(20.7%) were dual substance users. Pre pregnancy substance use (AOR = 27.25, CI: 14.107-52.66), partner substance use (AOR = 3.704 CI: 1.839-7.464), family substance use (AOR = 3.447 CI: 1.69-7.031) and the amount of monthly household income (AOR = 3.397, 95% CI: 1.316-8.766) were found to be statistically significant and positively associated with substance use during pregnancy. CONCLUSION: The magnitude of antenatal substance use in the study area was 26.5%. Pre- pregnancy substance use, partner substance use, monthly house hold income and family substance use were found to be positively associated with substance use during pregnancy. Therefore, health education which is inclusive of child bearing age women with their partner and family may be helpful to decrease antenatal substance use during pregnancy.