Abstract
Background: The study evaluated the risks for developing low birth weight (LBW), preeclampsia (PE) and postpartum hemorrhage (PPH) in relation to maternal socio-demographic, obstetric characteristics and clinical laboratory information obtained at 1st antenatal care (ANC) visit.Methods: The study included 268 pregnant women attending 1st ANC visit at the Bolgatanga Regional Hospital. Structured questionnaires were used to obtain socio-demographic and obstetric data from respondents. The main variables were LBW, PPH, PE, mode of delivery, residency, gestational age at 1st ANC visit, maternal age, sickling positivity, Hb at 1st ANC visit, Hb genotype and G6PD status. Odds ratio [OR, 95% confidence interval (CI)] for the association between sociodemographic, obstetric characteristics and clinical variables in relation to PE, LBW and PPH were assessed using logistic regression model.Results: The prevalence of PE, LBW and PPH were 25.4% (68/268), 15.7% (42/268) and 6.0% (16/268), respectively. For PE, delayed 1st ANC visit (AOR=16.82, 95% CI (3.61-78.5), p=0.000) and younger maternal age (AOR= 15.19, 95% CI (1.85-124.56), p=0.011) were independently associated with higher odds whereas vaginal delivery (AOR=0.32, 95% CI (0.15-0.71), p=0.015) was independently associated with reduced odds. Delayed 1st ANC visit (AOR=0.12, 95% CI (0.03-0.47)), p=0.002) independently reduced the risk of PPH whereas the male gender (AOR=7.75, 95% CI (1.60-37.51), p=0.011) independently increased the risk of PPH. Lastly, delayed 1st ANC visit (AOR=3.26, 95% CI (1.05-10.10), p=0.041) was independently associated with increased odds of LBW whereas vaginal delivery (AOR=0.36, 95% CI (0.17-0.74), p=0.006) was an independent risk factor for LBW in the multivariate model.Conclusion: The study identified delayed ANC visit as an independent risk factor for PE, LBW and PPH in Northern Ghana. Vaginal delivery and younger maternal age were also independent risk factors for PE. Additionally, the male gender was independently associated with PPH whereas vaginal delivery was independently associated with LBW. We recommend that public health education for pregnant women that highlights the importance of early ANC visit be enhanced. This will facilitate early identification and intervention for women with risk of foeto-maternal complications. Younger women should be educated on the dangers 48 of early marriages with its attendant foeto-maternal complications.
764 Operative vaginal delivery as an independent risk factor for maternal postpartum infection
