Publication:

Predictors of adverse pregnancy outcomes among postnatal women in a secondary hospital in Eastern Kenya

Background Adverse pregnancy outcomes remain a major public health concern in eastern Kenya, contributing to maternal and neonatal morbidity and mortality. These outcomes are influenced by socio-demographic, economic, intrapartum, and neonatal factors. This study examined their predictors at a County Referral Hospital in eastern Kenya to guide targeted interventions.

Methods An analytical cross-sectional design combining quantitative and qualitative methods was used among a sample of 210 postnatal women selected through systematic sampling. Data from medical records, focus group discussions, and key informant interviews was collected. Quantitative data were analyzed using descriptive statistics, chi-square tests, logistic regression, and qualitative data was thematically analysed.

Results Adverse outcomes occurred in 19.9% of participants, with stillbirth and neonatal asphyxia each accounting for 5.5%. Unmarried women had significantly higher rates (31.7% versus 15.1%, p=0.007). Prolonged third-stage labour (p=0.013), preterm delivery (p=0.008), abnormal birth weight (p<0.001), and low Apgar scores at 1, 5, and 10 minutes (p<0.001) were strongly associated. Logistic regression showed that longer first (p=0.050, AOR=1.002) and third (p=0.038, AOR=1.128) stages of labour increased the likelihood of adverse outcomes.

Conclusions Stillbirth and neonatal asphyxia were the most frequent complications. Strengthening intrapartum care, ensuring timely management of prolonged labour, improving monitoring of preterm and low-birth-weight infants, and enhancing support for unmarried mothers are key to reducing adverse pregnancy outcomes.