Predictors of poor birth outcome at public hospitals in Eastern Zone, Tigray, Ethiopia: Case-control study

Background: Poor birth outcomes include poor appearance of skin, low pulse, grimace, activity and respiration, stillbirth, low birth weight (LBW), and early birth, all of which can lead to infant death. Poor birth outcomes are a serious global public health concern, particularly in developing countries. Objective: To assess predictors of poor birth outcomes in Eastern zone public hospitals, Tigray Region, Ethiopia. Method: A hospital-based case-control study involving 294 (98 = cases and 196 = controls) from February – April 2020 was employed. A systematic sampling technique was employed in selecting controls, but the cases were enrolled consecutively. Data were collected through a structured questionnaire and chart review. Data were entered & analyzed by SPSS version 24. Bivariate and multivariable analysis was conducted to assess predictors of poor birth outcomes. Statistically significance was declared at P value <0.05 and 95% confidence interval. Results: A total of 294 mothers, 98 cases, and 196 controls, along with the participants’ index neonates, were participated. Mothers in rural areas were twice as likely to experience poor birth outcomes as those in urban areas [AOR 1.94; 95% CI (1.03, 3.64)]. Mothers who began ANC follow-up after 16 weeks of gestation were also twice as likely to develop poor birth outcomes compared to those who started ANC follow-up before 16 weeks of gestation (AOR 2.27;95% CI (1.18,4.35)). Mothers whose partners did not accompany them were three times more likely to experience poor birth outcomes than those whose partners did accompany them [AOR 3.41; 95% CI (1.32, 8.85)]. Neonates born via C/S were seven times more likely to have poor birth outcomes compared to those born via SVD [AOR 6.69; 95% CI (3.30, 13.57)]. Fetal presentations other than vertex were 15 times more likely to result in poor birth outcomes than vertex presentation [AOR 14.91; 95% CI (1.33, 167.02)]. Conclusions: Rural residence, non-partner accompany, late initiation of antenatal care visit, instrumental delivery, mal-presentation were significant predictors of poor birth outcomes. Emphasis should be given to tackle the problems and save the life of the newborn through better and strengthened Antenatal care follow-up.