Perinatal maternal infections among mothers attending an urban Ghanaian hospital: clinical characteristics and predictors of infections

Perinatal maternal infections (PMIs) during the perinatal period contribute significantly to maternal and infant morbidity and mortality, especially in low- and middle-income countries. Yet, limited research has empirically assessed the predictors of perinatal maternal infections in our context. Using the Socio-Ecological Model (SEM) as a theoretical framework, we designed this study to determine the predictors of perinatal maternal infections among mothers attending an urban district hospital. We engaged 416 postnatal mothers in a facility-based cross-sectional study through systematic sampling using the postnatal attendance register. We conducted a survey using a designed questionnaire in Google Forms to collect the data. In this study, the questionnaire was subjected to Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) to establish its construct validity and internal consistency. Additionally, we utilised descriptive statistics to summarise the scores of perinatal maternal infections. Furthermore, Pearson correlation was deployed to examine the associations between maternal demographics and PMIs, while Multiple Linear Regression (MLR) was used to identify the predictors of perinatal infections. All the tests were conducted at the statistical significance of p < .05. Perinatal maternal infections showed moderate scores among postnatal mothers, with mean scores ranging from 2.0 to 3.2. We found that the diagnosis of infections was about 55.9%, while urinary tract infections accounted for 54.5% among the mothers. The common symptoms of infections exhibited by the mothers included fever (48.2%), dysuria (52.6%), and abnormal vaginal discharge (46.8%). We also found evidence of puerperal sepsis (40.3%) contributed by surgical site infections (34.3%). The infections were managed with prescribed antibiotic therapy (64.0%) at the outpatient level, with low hospitalisation rates (31.3%). The regression analysis identified residence, gravidity, and mode of delivery as possible predictors, explaining 21.4% of variance in PMIs. Perinatal maternal infections remain a common clinical problem among postnatal mothers, particularly at the district level. Our findings indicate moderate predictors of urinary tract infections and puerperal sepsis, which are common among mothers with caesarean deliveries. Although there are functional management strategies for these infections in the study context, our findings indicate the need for further research to be conducted using longitudinal designs to examine causal pathways and evaluate the intervention effects. In the meantime, there is a need to intensify education on infection prevention practices among postnatal mothers, including hand washing, use of clean pads, clean wound care, and adherence to antibiotic therapy during the perinatal period.