Association between maternal mortality and caesarean section in Ethiopia: a national cross-sectional study

BMC Pregnancy and Childbirth

Tefera Taddele¹  Catherine Chojenta²  Deborah Loxton²  Ayele Geleto³ 

[1] Health System and Reproductive Health Directorate, the Ethiopian Public Health Institute, Addis Ababa, Ethiopia;Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, the University of Newcastle, Newcastle, Australia;School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia;Research Centre for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, the University of Newcastle, Newcastle, Australia;

关键词: Maternal mortality ratio;    caesarean section rate;    association;    Ehiopia;   

DOI  :  10.1186/s12884-020-03276-1

来源: Springer

【 摘 要 】

BackgroundSeveral studies concluded that there is a reduction of maternal deaths with improved access to caesarean section, while other studies showed the existence of a direct association between the two variables. In Ethiopia, literature about the association between maternal mortality and caesarean section is scarce. This study was aimed to assess the association between maternal mortality ratios and caesarean section rates in hospitals in Ethiopia.MethodsAnalysis was done of a national maternal health dataset of 293 hospitals that accessed from the Ethiopian Public Health Institute. Hospital specific characteristics, maternal mortality ratios and caesarean section rates were described. Pearson’s correlation coefficient was used to determine the direction of association between maternal mortality ratios and caesarean section rate, taking regions into consideration. Presence of a linear association between these variables was declared statistically significant at p-value < 0.05.ResultsThe overall maternal mortality ratio in Ethiopian hospitals was 149 (95% CI: 136–162) per 100,000 livebirths. There was significant regional variation in maternal mortality ratios, ranging from 74 (95% CI: 51–104) per 100,000 livebirths in Tigray region to 548 (95% CI: 251-1,037) in Afar region. The average annual caesarean section rate in hospitals was 20.3% (95% CI: 20.2–20.5). The highest caesarean section rate of 38.5% (95% CI: 38.1–38.9) was observed in Addis Ababa, while the lowest rate of 5.7% (95% CI: 5.2–6.2) occurred in Somali region. At national level, a statistically non-significant inverse association was observed between maternal mortality ratios and caesarean section rates. Similarly, unlike in other regions, there were inverse associations between maternal mortality ratios and caesarean section rates in Addis Ababa, Afar Oromia and Somali, although associations were not statistically significant.ConclusionsAt national level, a statistically non-significant inverse association was observed between maternal mortality ratios and caesarean section rates in hospitals, although there were regional variations. Additional studies with a stronger design should be conducted to assess the association between population-based maternal mortality ratios and caesarean section rates.

【 授权许可】

CC BY