Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study
Abstract Background Maternal mortality among obstetric patients admitted to intensive care units (ICUs) remains disproportionately high in low-resource settings. Limited evidence exists regarding its determinants in such contexts. This study aimed to identify factors associated with maternal mortali...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-08-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-025-07979-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849225858927034368 |
|---|---|
| author | Tigist Nega Alemu Wondimagegn Genaneh Shiferaw Wakgari Binu Daga Yordanos Sisay Behailu Balcha |
| author_facet | Tigist Nega Alemu Wondimagegn Genaneh Shiferaw Wakgari Binu Daga Yordanos Sisay Behailu Balcha |
| author_sort | Tigist Nega Alemu |
| collection | DOAJ |
| description | Abstract Background Maternal mortality among obstetric patients admitted to intensive care units (ICUs) remains disproportionately high in low-resource settings. Limited evidence exists regarding its determinants in such contexts. This study aimed to identify factors associated with maternal mortality among obstetric patients admitted to the ICU of Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia. Methods An unmatched case–control study was conducted from November 23 to December 23, 2023, at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia. A total of 378 obstetric ICU admissions over a 10-year period were reviewed, including 126 maternal deaths (cases) and 252 survivors (controls), selected using simple random sampling. Data were extracted using a structured, pretested checklist. Bivariate analysis was used to identify candidate variables (p < 0.25) for inclusion in multivariable analysis where in statistical significance was established at p < 0.05. Strength of association was expressed by Adjusted odds ratios (AOR) with 95% confidence. Results Significant predictors of maternal mortality included ICU stay of fewer than five days [AOR = 2.61; 95% CI: 1.41–4.82], use of invasive mechanical ventilation [AOR = 3.82; 95% CI: 1.90–7.30], presence of shock [AOR = 6.80; 95% CI: 3.24–14.14], and multi-organ failure [AOR = 2.69; 95% CI: 1.03–6.98]. Mild [AOR = 0.19; 95% CI: 0.09–0.43] and moderate [AOR = 0.08; 95% CI: 0.04–0.18] reductions in the level of consciousness on admission were associated with lower odds of mortality compared to severe reduction. Conclusion and recommendations Shorter ICU stay, invasive mechanical ventilation, development of shock, and multi-organ failure were independently associated with increased maternal mortality. Improved ICU triage protocols, early identification of complications, and appropriate critical care interventions are essential to improve maternal outcomes. |
| format | Article |
| id | doaj-art-a38b072440bd4e099f47d3f71a89eb8a |
| institution | Kabale University |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-a38b072440bd4e099f47d3f71a89eb8a2025-08-24T11:56:31ZengBMCBMC Pregnancy and Childbirth1471-23932025-08-0125111210.1186/s12884-025-07979-1Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control studyTigist Nega Alemu0Wondimagegn Genaneh Shiferaw1Wakgari Binu Daga2Yordanos Sisay3Behailu Balcha4Department of Emergency and Critical Care Nursing, Wolaita sodo UniversityDepartment of Emergency and Critical Care Nursing, Wolaita sodo UniversityDepartment of Emergency and Critical Care Nursing, Wolaita sodo UniversityDepartment of Emergency and Critical Care Nursing, Wolaita sodo UniversityDepartment of Emergency and Critical Care Nursing, Wolaita sodo UniversityAbstract Background Maternal mortality among obstetric patients admitted to intensive care units (ICUs) remains disproportionately high in low-resource settings. Limited evidence exists regarding its determinants in such contexts. This study aimed to identify factors associated with maternal mortality among obstetric patients admitted to the ICU of Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia. Methods An unmatched case–control study was conducted from November 23 to December 23, 2023, at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia. A total of 378 obstetric ICU admissions over a 10-year period were reviewed, including 126 maternal deaths (cases) and 252 survivors (controls), selected using simple random sampling. Data were extracted using a structured, pretested checklist. Bivariate analysis was used to identify candidate variables (p < 0.25) for inclusion in multivariable analysis where in statistical significance was established at p < 0.05. Strength of association was expressed by Adjusted odds ratios (AOR) with 95% confidence. Results Significant predictors of maternal mortality included ICU stay of fewer than five days [AOR = 2.61; 95% CI: 1.41–4.82], use of invasive mechanical ventilation [AOR = 3.82; 95% CI: 1.90–7.30], presence of shock [AOR = 6.80; 95% CI: 3.24–14.14], and multi-organ failure [AOR = 2.69; 95% CI: 1.03–6.98]. Mild [AOR = 0.19; 95% CI: 0.09–0.43] and moderate [AOR = 0.08; 95% CI: 0.04–0.18] reductions in the level of consciousness on admission were associated with lower odds of mortality compared to severe reduction. Conclusion and recommendations Shorter ICU stay, invasive mechanical ventilation, development of shock, and multi-organ failure were independently associated with increased maternal mortality. Improved ICU triage protocols, early identification of complications, and appropriate critical care interventions are essential to improve maternal outcomes.https://doi.org/10.1186/s12884-025-07979-1Maternal mortalityIntensive care unitUnmatched case controlWolaita Sodo |
| spellingShingle | Tigist Nega Alemu Wondimagegn Genaneh Shiferaw Wakgari Binu Daga Yordanos Sisay Behailu Balcha Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study BMC Pregnancy and Childbirth Maternal mortality Intensive care unit Unmatched case control Wolaita Sodo |
| title | Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study |
| title_full | Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study |
| title_fullStr | Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study |
| title_full_unstemmed | Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study |
| title_short | Determinants of maternal mortality among obstetric patients admitted to intensive care unit of Wolaita Sodo comprehensive specialized hospital, Southern Ethiopia: unmatched case-control study |
| title_sort | determinants of maternal mortality among obstetric patients admitted to intensive care unit of wolaita sodo comprehensive specialized hospital southern ethiopia unmatched case control study |
| topic | Maternal mortality Intensive care unit Unmatched case control Wolaita Sodo |
| url | https://doi.org/10.1186/s12884-025-07979-1 |
| work_keys_str_mv | AT tigistnegaalemu determinantsofmaternalmortalityamongobstetricpatientsadmittedtointensivecareunitofwolaitasodocomprehensivespecializedhospitalsouthernethiopiaunmatchedcasecontrolstudy AT wondimagegngenanehshiferaw determinantsofmaternalmortalityamongobstetricpatientsadmittedtointensivecareunitofwolaitasodocomprehensivespecializedhospitalsouthernethiopiaunmatchedcasecontrolstudy AT wakgaribinudaga determinantsofmaternalmortalityamongobstetricpatientsadmittedtointensivecareunitofwolaitasodocomprehensivespecializedhospitalsouthernethiopiaunmatchedcasecontrolstudy AT yordanossisay determinantsofmaternalmortalityamongobstetricpatientsadmittedtointensivecareunitofwolaitasodocomprehensivespecializedhospitalsouthernethiopiaunmatchedcasecontrolstudy AT behailubalcha determinantsofmaternalmortalityamongobstetricpatientsadmittedtointensivecareunitofwolaitasodocomprehensivespecializedhospitalsouthernethiopiaunmatchedcasecontrolstudy |