Determinants of Adverse Birth Outcomes among Mothers with Cardiovascular Problems in Addis Ababa Public Hospitals, Ethiopia, 2024: Unmatched Case-Control Study

Abstract

Abstract Introduction: - Adverse birth outcomes, such as low birth weight, preterm delivery, and fetal mortality are common in many regions including Ethiopia and sub-Saharan Africa, where pregnant women with cardiovascular disease are at risk for the condition. However, the adverse birth outcomes of women with cardiovascular diseases are have not yet studied in Ethiopia. Objective: - This study aims to assess determinants of adverse birth outcomes among mothers with cardiovascular problems in Addis Ababa public hospitals, 2024. Methods: -unmatched case-control study was conducted. The sample size was taken by simple random sampling & distributed in a 1:1 ratio to the case and control. Data was collected with a structured checklist by Kobo data collection software. Bivariate and unconditional logistic regression analysis was done, variables with a p-value less than 0.25 selected as a candidate variable. Using SPSS version 26, the analysis was utilized after checking the logistic regression model's fundamental assumptions. Variables with a P value <0.05 were considered statistically significant, and the odds ratio with a 95% confidence interval was used as a measure of association. Result: - Mothers who had hemoglobin levels below 11 g/dl during admission for labor were almost four times more at risk to have an adverse birth outcome compared to those who had levels of 11 g/dl or higher (AOR = 3.70, 95% CI: 2.54–5. 38; p-value <0.001). Furthermore, Women who hadn't taken their medication or had stopped taking it before getting pregnant were 1.4 times at risk to have an adverse birth outcome than those who were taking it. (AOR = 1.43, 95% CI: 1.15–1.77; P-value 0.001). Mothers who received a new diagnosis during their current pregnancy were twice at risk to have an adverse birth outcome than who did not receive the new medical diagnosis. (AOR = 2.37, 95% CI: 1.67–3.37; P-value<0.001). Additionally, Mothers who did not receive ANC visits were by 1.7 times at risk to experience an adverse birth outcome than who did receive ANC visits (AOR = 1.73, 95% CI: 1.30–2.29; p-value<0.001) Conclusion: -The study determined that not using or discontinuation of cardiovascular medications before pregnancy, hemoglobin level below 11g/dl, receiving a new diagnosis during the current pregnancy and not having ANC follow up were associated with determinants of adverse birth out comes among mothers with cardiovascular problems. Key words: Addis Ababa, Adverse birth outcome, Cardiovascular disease, Ethiopia, Pregnancy.