Abstract

Cesarean section (CS) refers to the delivery of fetus, placenta, and membrane through an abdominal and uterine incision after 28 completed weeks of gestation. This mode of delivery minimizes both maternal and perinatal morbidity and mortality; however, it is associated with lower but severe neonatal outcomes as compared to vaginal delivery. Thus, the current study was aimed to assess the current status of adverse neonatal outcomes and its contributing factors. A retrospective cross-sectional study was employed from July 2016 to August 2017. The data were collected from records of mothers who gave birth through CS in Arba Minch General Hospital using a structured record review checklist. Simple random sampling technique was used to select records for extracting data. Variables with p-value <0.25 in the bivariate model were entered into multivariable model to declare statistical significance at p-value <0.05. Results revealed that nearly one-third of newborns delivered through cesarean section developed adverse outcome. Rural residency (AOR: 2.96; 95% CI: 1.47, 5.96), fetus with cephalopelvic disproportion (AOR: 2.58; 95% CI: 1.23, 5.42), CS with general anesthesia (AOR 3.28, 95% CI: 1.21, 8.93) and maternal complication due to CS (AOR: 2.38; 95% CI: 1.21, 4.70) were determinants of adverse neonatal outcome. Newborns delivered at term, have lower risk of adverse outcome as compared to pre-term (AOR: 0.11; 95% CI: 0.01, 0.93). Mothers with prolonged rupture of  membrane before CS was 3.33 times more likely to deliver a baby with adverse outcome than their counterparts (AOR: 3.33; 95% CI: 1.13, 9.84). It can therefore be concluded that nearly one-third of newborns delivered through cesarean section developed an adverse outcome. Each caesarian delivery with cephalopelvic disproportion, pre-term caesarian delivery, and under general anesthesia should get prompt and appropraite management.

Key words: Adverse, neonatal outcome, cesarean delivery, Ethiopia.

Abbreviation

ANC, Antenatal care; PNC, postnatal care; EDHS, Ethiopian Demographic and Health Survey; WHO, World Health Organization; AOR, adjusted odds ratio; CI, confidence interval; NICU, neonatal intensive care unit, CS, cesarean section.