Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.

BACKGROUND: The burden of maternal morbidity is high in developing countries including Nepal. This study investigated obstetric complications and rural-urban difference in cesarean delivery rate in Western Nepal. METHODS: A community-based cohort study was conducted in the Rupandehi district of West...

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Main Authors: Khanal, V., Karkee, R., Lee, Andy, Binns, Colin
Format: Journal Article
Published: 2016
Online Access:http://hdl.handle.net/20.500.11937/31045
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author Khanal, V.
Karkee, R.
Lee, Andy
Binns, Colin
author_facet Khanal, V.
Karkee, R.
Lee, Andy
Binns, Colin
author_sort Khanal, V.
building Curtin Institutional Repository
collection Online Access
description BACKGROUND: The burden of maternal morbidity is high in developing countries including Nepal. This study investigated obstetric complications and rural-urban difference in cesarean delivery rate in Western Nepal. METHODS: A community-based cohort study was conducted in the Rupandehi district of Western Nepal during January-October, 2014, by interviewing 735 mothers within one month postpartum. The prevalence of obstetric complications was reported via frequency distribution, while factors associated with cesarean delivery were assessed using logistic regression analysis. RESULTS: The prevalence of adverse obstetric symptoms during antenatal, intranatal and postnatal periods were 19.7 %, 27.8 % and 21.6 %, respectively. In total, 81 (11.0 %) mothers reported having stillbirths. The cesarean delivery rate was 14.1 % overall but was four times higher in the urban (23.0 %) than in the rural areas (5.8 %). Prolonged labor (19.0 %) and heavy bleeding (16.7 %) were common among rural women. Logistic regression analysis confirmed that cesarean section was more likely for mothers residing in urban areas than in rural areas (adjusted odds ratio 3.41; 95 % confidence interval 2.01 to 5.78). CONCLUSIONS: About one in five mothers reported some adverse obstetric symptoms. Obstetric problems were more common in the rural areas, whereas cesarean delivery rate was much higher in the urban areas. Further investigations are required to determine whether these cesarean sections are medically warranted or provider induced.
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spelling curtin-20.500.11937-310452017-09-13T15:11:18Z Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study. Khanal, V. Karkee, R. Lee, Andy Binns, Colin BACKGROUND: The burden of maternal morbidity is high in developing countries including Nepal. This study investigated obstetric complications and rural-urban difference in cesarean delivery rate in Western Nepal. METHODS: A community-based cohort study was conducted in the Rupandehi district of Western Nepal during January-October, 2014, by interviewing 735 mothers within one month postpartum. The prevalence of obstetric complications was reported via frequency distribution, while factors associated with cesarean delivery were assessed using logistic regression analysis. RESULTS: The prevalence of adverse obstetric symptoms during antenatal, intranatal and postnatal periods were 19.7 %, 27.8 % and 21.6 %, respectively. In total, 81 (11.0 %) mothers reported having stillbirths. The cesarean delivery rate was 14.1 % overall but was four times higher in the urban (23.0 %) than in the rural areas (5.8 %). Prolonged labor (19.0 %) and heavy bleeding (16.7 %) were common among rural women. Logistic regression analysis confirmed that cesarean section was more likely for mothers residing in urban areas than in rural areas (adjusted odds ratio 3.41; 95 % confidence interval 2.01 to 5.78). CONCLUSIONS: About one in five mothers reported some adverse obstetric symptoms. Obstetric problems were more common in the rural areas, whereas cesarean delivery rate was much higher in the urban areas. Further investigations are required to determine whether these cesarean sections are medically warranted or provider induced. 2016 Journal Article http://hdl.handle.net/20.500.11937/31045 10.1186/s12978-016-0128-x fulltext
spellingShingle Khanal, V.
Karkee, R.
Lee, Andy
Binns, Colin
Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.
title Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.
title_full Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.
title_fullStr Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.
title_full_unstemmed Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.
title_short Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study.
title_sort adverse obstetric symptoms and rural-urban difference in cesarean delivery in rupandehi district, western nepal: a cohort study.
url http://hdl.handle.net/20.500.11937/31045