Incidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Uganda: a prospective

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dc.contributor.authorGeoffrey Okot
dc.contributor.authorSamuel Omara
dc.contributor.authorMusa Kasujja
dc.contributor.authorFrancis Pebolo Pebalo
dc.contributor.authorPetrus Baruti
dc.contributor.authorNaranjo Almenares Ubarnel
dc.date.accessioned2025-09-01T10:46:07Z
dc.date.available2025-09-01T10:46:07Z
dc.date.issued2024
dc.descriptionWe extend our gratitude to all participants who willingly took part in this study. Ethical approval and consent to participate All research methodologies adhered to ethical principles and received approval from the Research Ethics Committee (REC) of Bishop Stuart University, under REC number BSU-REC-2023-113. Additionally, permission was granted by the Administration of Jinja Regional Referral Hospital. Prior to participation, all individuals were fully informed about the study’s objectives, and their informed consent was obtained
dc.description.abstractBackground: High rates of adverse neonatal outcomes in resource-limited settings are multifactorial, varying by country, region, and institution. In sub-Saharan Africa, the majority of adverse neonatal outcomes are intrapartum related, and studies in Uganda have shown that referral in labor is a major determinant of adverse neonatal outcomes. This study aimed to assess the incidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Eastern Uganda. Materials and methods: This was a prospective cohort study involving 265 women who were referred in labor to Jinja Regional Referral Hospital in Uganda with emergency obstetric complications. The exposure of interest was being referred with obstetrical emergency, and the outcome variable was adverse neonatal outcomes. The study was conducted between July 5, 2023, and October 5, 2023. Consecutive sampling was used, and data on sociodemographic and obstetric factors, referral related factors, as well as the primary outcome variable (adverse neonatal outcome) were collected via interviewer-administered questionnaires. The data were then cleaned, coded, and analyzed using STATA version 14. Log-binomial regression determined risk ratios and associations for factors related to adverse neonatal outcomes. Variables with p-values < 0.2 in bivariable analysis were included in the multivariable analysis, where significance was set at p < 0.05. Results: Of the 265 women exposed to emergency obstetrical referrals, 40% experienced adverse neonatal outcomes, a composite measure including neonatal intensive care admission (27.6%), low Apgar score (23.8%), fresh stillbirth (11.3%), early-onset neonatal infection (6.8%), and early neonatal death (2.3%). Factors significantly associated with adverse neonatal outcomes were: maternal age ≥ 35 years (aRR = 1.72, CI:1.194–2.477, p value = 0.004 Conclusions: The study found a high rate of adverse neonatal outcomes among emergency obstetric referrals, with 40% of participants facing issues like ICU admissions, low Apgar scores and fresh stillbirth. Key factors included maternal age over 35, antepartum hemorrhage, and non-reassuring fetal status. These results highlight the urgent need for targeted interventions in emergency obstetric care. Strategies should enhance referral systems, improve facility preparedness, train healthcare providers, and educate communities on timely referrals and managing high-risk pregnancies.
dc.description.sponsorshipNo grants were received for this study.
dc.identifier.urihttp://hdl.handle.net/20.500.14270/617
dc.language.isoen
dc.publisherBMC Pregnancy and Childbirth
dc.subjectObstetrical emergency
dc.subjectReferrals
dc.subjectAdverse neonatal outcomes
dc.titleIncidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Uganda: a prospective
dc.typeArticle

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