Adverse birth outcome: a comparative analysis between cesarean section and vaginal delivery at Felegehiwot Referral Hospital, Northwest Ethiopia: a retrospective record review

Introduction: Some studies favor elective cesarean delivery, and other surveys benefit vaginal delivery, while others emphasize that the quality of care during labor, birth, and immediate postpartum period plays a great role than the route of delivery. However, little information is locally available regarding the incidences of adverse birth outcome with respect to the route of delivery. Methods: This study was a retrospective analysis of eligible patient records that included 3,003 pregnant women who had undergone either cesarean or vaginal delivery from July 1, 2012, to June 31, 2013. Pretested questionnaire was used to collect the data. The completeness and consistency of the data were checked, cleaned, and double entered to EPI-INFO 3.5.2 and analyzed with SPSS V20. Independent sample t-test and chi-square test were conducted to compare the outcome of vaginal delivery and cesarean section (CS) using index variables. Significance was taken at P<0.05. Results: Among the enrolled women, 760 mothers had CS delivery and the remaining 2,243 mothers delivered vaginally. Children born through CS (mean =6.83, standard deviation =1.31) had a significantly lower first-minute Apgar score than those in the vaginal delivery group (mean =7.19, standard deviation =1.18, P=0.001). Similarly, the observed respiratory distress syndrome (c(2)=0.09, P=0.793) and neonatal transfer rate to neonatal intensive care unit (c(2)=0.086, P=0.766) were more in neonates delivered by CS than those in the vaginally delivered group. Besides, the observed neonatal death (c(2)=0.675, P=0.411) and maternal death (c(2)=8.878, P=0.003) were higher among CS deliveries compared with vaginal deliveries. Conclusion: Neonatal and maternal morbidity and mortality appear to be more in CS than in vaginal delivery. Therefore, decision to perform CS should be based on clear, compelling, and well-supported justifications.