Determinants of Maternal Mortality During Child Birth Among Mothers Delivering at Yopougon Teaching Hospital

Abstract

Background of the study: In Côte d'Ivoire, mother and child health is a major concern as maternal mortality persists at a high level. Objective: The main objective of the study was to establish factors contributing to maternal mortality during child birth among mothers delivered at Yopougon teaching hospital between January 2015 and July 2017. Methodology: This was a case control study conducted using secondary data from 216 mothers who delivered at Yopougon teaching hospital between January 2015 and July 2017. The cases included mothers who died during child birth and the controls include mothers who went through a successful delivery process. Patient information (education level, age, gravida status, ANC attendance, time of delivery and delivery complications presented during birth) was collected from the hospital records. Univariate analysis was done to describe the data; appropriate descriptive statistics depending on type of data and distribution were reported. Numerous binary logistic regression models were fitted to determine factors extensively linked to the risk of a mother dying during child birth. Results: The education level of the mother (OR=0.05, p<0.001), time of delivery (daytime/night shift) (OR=0.12, p<0.001) and number of ANC visits attended (OR=0.05, p<0.001) were found to have a significant effect on the odd of a mother dying during child birth Among the complications of child delivery reported, hemorrhage (OR=3.25, p<0.05) was significantly associated with maternal mortality. A mother presenting with hemorrhage was 3.2 times more probable to die during child birth than a mother with Eclampsia. Delivery time also played a role in maternal mortality risk: a mother who delivered during the day was 88% less likely to die than who delivered during the day. Though not statistically significant, a mother who has been pregnant before (multigravida) less likely to die during child birth xi compared to one who is carrying her first pregnancy; also not statistical significant, mother older than 24 years was 13% more likely to die during child birth compared to a mother aged 24 years or younger. Conclusion: The study findings demonstrated and emphasized the need to improve the literacy levels of women in Ivory Coast especially of matters of reproductive health and reinforce ANC attendance among expectant women. This will improve awareness level of mothers on their health enabling them to know when and where to seek medical attention in case of complications that would put the mother at risk. The staff rooster need also to be adjusted to allow better performance mainly for night duty staff. Sensitization of potential risky mother (primigravida, older than 24 years) to deliver in a referral facility as first contact point.