Non-reassuring fetal heart rate and associated factors among laboring mothers at southern public hospitals in Ethiopia: a poisson regression model

Abstract

Non-reassuring fetal heart rate is a critical indicator of fetal well-being. It is used to predict fetal hypoxia and metabolic acidosis due to insufficient fetal oxygenation and is the major contributor to perinatal mortality and morbidity. This study aimed to assess the magnitude of non-reassuring fetal heart rate status and its associated factors among laboring mothers at South Omo public Hospitals, in Southern Ethiopia. An institution-based cross-sectional study was conducted among randomly selected 448 laboring mothers from June 11 to August 30, 2023. Data were collected using a pre-tested structured questionnaire. Data were entered and analyzed using Epidata version 4.6 and STATA version 17. Poisson regression with a robust variance model was executed, and all independent variables whose p-value < 0.25 in the bivariable analysis were entered into the multivariable analysis. An adjusted prevalence ratio (APR) with 95% confidence intervals (CI) was reported and statistical significance was declared at p < 0.05. The magnitude of non-reassuring fetal heart rate was 41.5% (95% CI 37, 46%). No antenatal follow-up (APR 3.46; 95% CI 2.46, 4.88), having obstetric complications (APR 2.71; 95% CI 2.06, 3.59), alcohol consumption during pregnancy (APR 1.30; 95% CI 1.08, 1.57), being referred from other facility (APR 1.57; 95% CI 1.21, 2.03), meconium stained amniotic fluid (APR 1.89; 95% CI 1.51, 2.37), and presence of nuchal cord (APR 1.70; 95% CI 1.39, 2.08) were significantly associated factors with non-reassuring fetal heart rate. Two in five childbirth suffred from non-reassuring fetal heart rate. The identified factors highlight the importance of preconception care and comprehensive prenatal services that could be strengthened with a recommendation for early antenatal follow up and intrapartum monitoring so as to improve fetal outcomes.