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

    238985_238985.pdf (577.3Kb)
    Access Status
    Open access
    Authors
    Khanal, V.
    Karkee, R.
    Lee, Andy
    Binns, Colin
    Date
    2016
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Khanal, V. and Karkee, R. and Lee, A. and Binns, C. 2016. Adverse obstetric symptoms and rural-urban difference in cesarean delivery in Rupandehi district, Western Nepal: a cohort study. Reproductive Health. 13: 17.
    Source Title
    Reprod Health
    DOI
    10.1186/s12978-016-0128-x
    School
    Epidemiology and Biostatistics
    Remarks

    This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by/4.0/

    URI
    http://hdl.handle.net/20.500.11937/31045
    Collection
    • Curtin Research Publications
    Abstract

    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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