Adverse neonatal outcomes and associated factors among births through operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: A facility-based retrospective cross-sectional study

BACKGROUND: Obstetric interventions can improve maternal and neonatal outcomes when performed appropriately by skilled healthcare professionals. Appropriate use of forceps and vacuum extraction can reduce neonatal complications associated with operative vaginal deliveries. However, there is limited evidence on the prevalence of adverse neonatal outcomes and associated factors among operative vaginal deliveries in Northwest Ethiopia. OBJECTIVE: This study aimed to assess the prevalence of adverse neonatal outcomes and associated factors among births through operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital in Northwest Ethiopia. METHODS: A facility-based retrospective cross-sectional study was conducted among 303 mothers who underwent operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital from September 1, 2019, to August 30, 2021. Data was extracted using a structured questionnaire. The collected data was entered into Epi-Data version 3.1 statistical software and exported to IBM SPSS statistics version 24 for data analysis. Descriptive statistics were used to summarize the participants' characteristics and neonatal outcomes. Bivariable logistic regression analysis was performed to identify candidate variables. Variables with a p-value < 0.25 were entered into the multivariable logistic regression model. Adjusted odds ratio (AOR) with 95% confidence intervals (CIs) were calculated to assess the strength of associations. Statistical significance was declared at a p-value of < 0.05 in the multivariable logistic regression analysis. RESULTS: The prevalence of adverse neonatal outcomes among births delivered through operative vaginal delivery was 23.1% (95% CI: 18.68-28.21). The mean age and standard deviation of the study participants were 25.19 ± 4.7 years. All participants were married and 154 (50.8%) had obtained a college education or higher. The presence of grade ½ (AOR = 4.13, 95% CI: 1.96-8.69) and grade three meconium-stained amniotic fluid (AOR = 24.9, 95% CI: 6.14-46.06) and primigravidity (AOR = 2.49, 95% CI: (1.13-5.16) were significantly associated with adverse neonatal outcomes. CONCLUSIONS: Adverse neonatal outcomes among births through operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital were high. Close intrapartum monitoring and early obstetric intervention among women with meconium-stained amniotic fluid and primigravid mothers are essential to reduce adverse neonatal outcomes associated with operative vaginal delivery.