Maternal Care Disparities: Impact Of Pregnancy Profiles, Socioeconomic Factors, and Age on Maternal Outcomes

Authors

  • Hemasa Gul Mardan Medical Complex
  • Hina iftikhar Basic Health Unit, Kot Ismailzai
  • Amara Shah Women Medical Officer, RHC Gariyala
  • Sana Adil District Head Quarter
  • Aneesa Anum Department of Radiology, District Head Quarter

DOI:

https://doi.org/10.37762/jgmds.10-3.414

Keywords:

Pregnancy, Age, Gestational, Socioeconomic status, Maternal

Abstract

OBJECTIVES

This study aimed to evaluate the impact of pregnancy profiles, socioeconomic factors, and age on maternal at teaching hospitals in Mardan, Khyber Pakhtunkhwa.

METHODOLOGY

This descriptive-exploratory/qualitative study was conducted at the genealogical outside-patient department of the Mardan Medical Complex, with the approval of the ethics committee. A total of 1187 patients attended the complex between January 2021 and January 2022. Informed consent was obtained, and a comprehensive history and physical examination were conducted using a pre-designed proforma. Patients meeting specific criteria, such as gestational age >36 weeks, singleton pregnancies, and absence of maternal co-morbidities, were included. Exclusion criteria encompassed conditions such as antepartum haemorrhage and fetal anomalies. Data analysis was performed using SPSS-24 version, ensuring the confidentiality and anonymity of participants.

RESULTS
Out % of 1187 patients, 48% had previous pregnancies (multiparous), while 52% were experiencing their first pregnancy (primiparous). Gestational age distribution showed that 45% of cases fell within the 36-38 week range, and 55% were between 39-40 weeks. Regarding booking status, 29% of patients were booked, while 71% were unbooked. Finally, the socioeconomic status analysis indicates that 61% of cases were above the poverty line, while 39% were below. These findings highlight important factors such as previous pregnancies, gestational age, booking status, and socioeconomic status that can influence maternal care and outcomes. Among the different age groups, the <20 age group had the highest percentage of spontaneous deliveries (31%), while the >30 age group had the highest percentage of cesarean sections (25%). Induced labour rates were relatively consistent across age groups. Not being in labour was more prevalent in the 25-30 and >30 age groups.

CONCLUSION

The findings highlight that important factors such as previous pregnancies, gestational age, booking status, and socioeconomic status can influence maternal care and outcomes.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Author Biographies

Hemasa Gul, Mardan Medical Complex

HOD Gynea Ward,
Mardan Medical Complex

 

Hina iftikhar, Basic Health Unit, Kot Ismailzai

FCPS-II Gynea, Women Medical Officer,
Basic Health Unit, Kot Ismailzai

 

Amara Shah, Women Medical Officer, RHC Gariyala

MBBS, FCPS,
Women Medical Officer, RHC Gariyala

 

Sana Adil, District Head Quarter

MBBS, FCPS, Medical Officer,
District Head Quarter

 

Aneesa Anum, Department of Radiology, District Head Quarter

MBBS, FCPS-II, Registrar/Women Medical Officer,
Department of Radiology, District Head Quarter

References

Cameron L, Contreras Suarez D, Cornwell K. Understanding the determinants of maternal mortality: An observational study using the Indonesian Population Census. PloS one. 2019 Jun 3;14(6):e0217386 DOI: https://doi.org/10.1371/journal.pone.0217386

Coates D, Homer C, Wilson A, Deady L, Mason E, Foureur M, Henry A. Indications for, and timing of, planned caesarean section: A systematic analysis of clinical guidelines. Women and Birth. 2020 Feb 1;33(1):22-34 DOI: https://doi.org/10.1016/j.wombi.2019.06.011

Dyer O. Covid-19: Many poor countries will see almost no vaccine next year, aid groups warn. BMJ: British Medical Journal (Online). 2020 Dec 11;371. DOI: https://doi.org/10.1136/bmj.m4809

Keag OE,Norman JE, Stock SJ Long-Term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis.PLoSMed 2018;15:e1002494 DOI: https://doi.org/10.1371/journal.pmed.1002494

Sandall J,Tribe RM,Avery L, et al. Short-Term and long-term effects of caesarean section on the health of women and children. Lancet 2018;392:1349–57. DOI: https://doi.org/10.1016/S0140-6736(18)31930-5

Sobhy S,Arroyo-Manzano D,Murugesu N, et al. Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: a systematic review and meta-analysis. Lancet 2019;393:1973–82 DOI: https://doi.org/10.1016/S0140-6736(18)32386-9

Betrán AP,Temmerman M,Kingdon C, et al. Interventions to reduce unnecessary caesarean sections in healthy women and babies. Lancet 2018;392:1358–68. DOI: https://doi.org/10.1016/S0140-6736(18)31927-5

Fouladi Z, Shaarbafchi Zadeh N, Shaikhvaisi Y, Alimoradnuri M, Bagheri F. The effect of healthcare reform plan to reduce the rate of cesarean in hospitals affiliated to Qom University of Medical Sciences. Military Caring Sciences Journal. 2018 Jan 10;4(3):207-12 DOI: https://doi.org/10.29252/mcs.4.3.207

Boatin AA,Schlotheuber A, Betran AP, et al. Within country inequalities in caesarean section rates: observational study of 72 low and middle incomecountries. BMJ 2018;360:k55 DOI: https://doi.org/10.1136/bmj.k55

Bahmaei J, Maleki A. Evaluation of the Effect of Health Sector Evolution Plan on the Rate of Cesarean Sections in Hospitals Affiliated to Abadan School of Medical Sciences. Journal of health research in community. 2019 Nov 10;5(3):52-60

Vora KS, Cottagiri SA, Saiyed S, Tailor PJPH. Public Health aspects of Cesarean section including overuse and underuse of the procedure. Int Res J Public Health. 2019;3:30.

Kingdon C,Downe S,Betrán AP. Non-Clinical interventions to reduce unnecessary caesarean section targeted at organizations, facilities and systems: systematic review of qualitative studies. PloS One 2018;13:e0203274 DOI: https://doi.org/10.1371/journal.pone.0203274

Opiyo N, Young C, Requejo JH, et al. Reducing unnecessary caesarean sections: scoping review of financial and regulatory interventions. Reprod Health 2020;17:133 DOI: https://doi.org/10.1186/s12978-020-00983-y

Dutta S, Dey B, Chanu S, Marbaniang E, Sharma N, Khonglah Y, Raphael V, Chanu SM. A retrospective study of placenta accreta, percreta, and increta in peripartum hysterectomies in a tertiary care institute in northeast India. Cureus. 2020 Nov 9;12(11) DOI: https://doi.org/10.7759/cureus.11399

Lotfi F, Lohivash S, Kavosi Z, Owjimehr S, Bayati M. The impact of Health Transformation Plan on natural vaginal delivery and cesarean section frequency in Iran: an interrupted time series analysis. BMC Research Notes. 2021 Dec;14(1):1-6 DOI: https://doi.org/10.1186/s13104-021-05677-7

Madhani Z, Aslani A, Kasraeian M. Development and Pilot Testing of a Mobile Based Patient Decision Aid for Childbirth Decision Making. InpHealth 2019 Jan 1 (pp. 223-229)

Nagy S, Papp Z. Global approach of the cesarean section rates. Journal of Perinatal Medicine. 2021 Jan 1;49(1):1-4 DOI: https://doi.org/10.1515/jpm-2020-0463

Rydahl E, Declercq E, Juhl M, Maimburg RD. Cesarean section on a rise—Does advanced maternal age explain the increase? A population register-based study. PloS one. 2019 Jan 24;14(1):e0210655 DOI: https://doi.org/10.1371/journal.pone.0210655

Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ. 2007;335(7628):1025 DOI: https://doi.org/10.1136/bmj.39363.706956.55

Chen I, Opiyo N,Tavender E, et al. Non-Clinical interventions for reducing unnecessary caesarean section. Cochrane Database Syst Rev 2018;9:CD005528 DOI: https://doi.org/10.1002/14651858.CD005528.pub3

Downloads

Published

2023-07-01

How to Cite

Gul, H. ., iftikhar, H. ., Shah, A. ., Adil, S. ., & Anum, A. . (2023). Maternal Care Disparities: Impact Of Pregnancy Profiles, Socioeconomic Factors, and Age on Maternal Outcomes. Journal of Gandhara Medical and Dental Science, 10(3), 65–68. https://doi.org/10.37762/jgmds.10-3.414