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. 2024 Aug;131(Suppl 3):78-87.
doi: 10.1111/1471-0528.17815. Epub 2024 Apr 4.

Outcomes and quality of care for women and their babies after caesarean section in Nigeria

Abiodun S Adeniran  1 , Duum C Nwachukwu  2 , Amaka N Ocheke  3 , Salisu O Mohammed  4 , Abdulkarim O Musa  5 , Silas Ochejele  6 , Rais S Ibraheem  7 , Samuel Pam  8 , Amsa B Mairami  9 , Aishatu A Gobir  10 , Eyinade K Olateju  11 , Fatimah J Baba  12 , Patricia F Medupin  13 , Grace Ahmed  14 , Sarah Ango  15 , Godwin Akaba  16 , Taofik O Ogunkunle  17 , Egwu Agada  18 , Luz Gibbons  19 , Olufemi T Oladapo  20 , Tina Lavin  20 , Jamilu Tukur  21 , Abiodun P Aboyeji  1 ; Maternal and Perinatal Database for Quality, Equity and Dignity Collaborators
Collaborators, Affiliations

Outcomes and quality of care for women and their babies after caesarean section in Nigeria

Abiodun S Adeniran et al. BJOG. 2024 Aug.

Abstract

Objective: To describe the outcomes and quality of care for women and their babies after caesarean section (CS) in Nigerian referral-level hospitals.

Design: Secondary analysis of a nationwide cross-sectional study.

Setting: Fifty-four referral-level hospitals.

Population: All women giving birth in the participating facilities between 1 September 2019 and 31 August 2020.

Methods: Data for the women were extracted, including sociodemographic data, clinical information, mode of birth, and maternal and perinatal outcomes. A conceptual hierarchical framework was employed to explore the sociodemographic and clinical factors associated with maternal and perinatal death in women who had an emergency CS.

Main outcome measures: Overall CS rate, outcomes for women who had CS, and factors associated with maternal and perinatal mortality.

Results: The overall CS rate was 33.3% (22 838/68 640). The majority of CS deliveries were emergency cases (62.8%) and 8.1% of CS deliveries had complications after delivery, which were more common after an emergency CS. There were 179 (0.8%) maternal deaths in women who had a CS and 29.6% resulted from complications of hypertensive disorders of pregnancy. The overall maternal mortality rate in women who delivered by CS was 778 per 100 000 live births, whereas the perinatal mortality at birth was 51 per 1000 live births. Factors associated with maternal mortality in women who had an emergency CS were being <20 or >35 years of age, having a lower level of education and being referred from another facility or informal setting.

Conclusions: One-third of births were delivered via CS (mostly emergency), with almost one in ten women experiencing a complication after a CS. To improve outcomes, hospitals should invest in care and remove obstacles to accessible quality CS services.

Keywords: Robson classification; caesarean section; maternal complications; maternal death; perinatal mortality.

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References

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