Speciality in Obstetrics and Gynecology

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Browsing Speciality in Obstetrics and Gynecology by Author "Dereje Worku"

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    Immediate Adverse Neonatal Outcomes and Associated Factors among Deliveries with Non-Reassuring Fetal Heart Rate in public Health Facilities of Asela Town, Ethiopia
    (2025-05-01) Dereje Worku
    Abstract Introduction: Non-reassuring fetal heart rate patterns during labor indicate potential fetal distress and may lead to adverse neonatal outcomes. However, local evidence on neonatal outcomes following Non-reassuring fetal heart rate status in Asela town public health facilities is limited. Objectives: To assess immediate adverse neonatal outcomes and associated factors among deliveries complicated by Non-reassuring fetal heart rate status at Asela public Health facilities in 2025. Methods: A facility-based cross-sectional study was conducted from October to December 2025 among 282 postpartum mothers at Asella referral and teaching hospital, Asela and Halial Health Centers. Participants were selected using systematic random sampling. Data were collected through interviews and chart reviews and analyzed using SPSS version 25. Factors associated with immediate adverse neonatal outcomes identified at a significance level of p < 0.05. Results: In the current study, 282 mothers were participated with the response rate of 100%. The prevalence of immediate adverse neonatal outcome was 30.9%(87) (CI: 25.5%, 36.5%) Of these cases, 29.4%(83) occurred at Asella referral and teaching hospital, 1.1%(3) at Asella health center, and 0.4%(1) at Hilal. The common adverse outcomes were neonatal care unit admission 87(30.9%), respiratory distress (13.8%), neonatal sepsis (12.4%), low APGAR scores at 5 minutes (5.3%), hypoxic encephalopathy (5.3%), and early neonatal death (3.2%). In multivariable analysis, maternal age ≥35 years (AOR: 15.86; 95% CI: 1.97, 52.2), bad obstetric history (AOR 9.87, 95% CI 1.61–34.2), Current pregnancy Complication (AOR 2.78, 95% CI 1.22–6.33), preterm neonates (<37 weeks) (AOR 15.27,95% CI 3.45–38.5), referral from another health facility (AOR 5.39, 95% CI 2.2–13.2),MSAF (AOR 4.37, 95% CI 1.86–10.24), prolonged ROM (AOR 1.22, 95% CI 1.03–4.24) diagnosis of Non-reassuring fetal heart rate status during the active first stage of labor (AOR 14.1, 95% CI 4.41–32.3), and during the second stage (AOR 14.7, 95% CI 3.35–29.51) were significant factors associated with immediate adverse neonatal outcomes. Conclusion: Nearly one-third of neonates among deliveries complicated by Non-reassuring fetal heart rate status experienced immediate adverse outcomes in Asela. The common adverse outcomes were neonatal care unit admission, respiratory distress, neonatal sepsis, low APGAR scores, HIE, and early neonatal lose. Advanced maternal age, a bad obstetric history, presence of current pregnancy complications, prematurity, and referral from other health facilities, meconium-stained amniotic fluid, prolonged rupture of membrane, and diagnosis of fetal compromise during active first stage of labor or second stage of labor were significant determinants. Therefore, I recommend better antenatal care, faster referral systems, and improved fetal monitoring and resuscitation Keywords: Magnitude, Outcome, Fetus, Neonates, Asela