Effect of bleeding during Pregnancy on Maternal and Perinatal Adverse Outcomes in Northern Ethiopia: - Using two years data from Hospital

Abstract Background Bleeding during pregnancy is an obstetric emergency associated with high maternal and neonatal morbidity and mortality. The effect of bleeding during pregnancy considered to be higher on maternal and perinatal adverse outcome. Hence this study assessed the effect of bleeding during pregnancy on maternal and perinatal adverse outcomes at ayder comprehensive specialized hospital, Mekelle, Tigray, Ethiopia, 2024. Method Institutional based retrospective cohort study was used among 539 mothers who gave birth from September 2019 to August 2021 at ayder comprehensive specialized hospital, Tigray, Ethiopia. mothers who gave birth with bleeding during pregnancy and without bleeding during pregnancy were grouped as exposed and nonexposed respectively. Systematic sampling method was used to select mothers from medical records. Data were collected from medical record by reviewing retrospectively. Modified poisson regression model was used to estimate relative risk and factors associated with adverse outcomes. Results Incidence of adverse maternal outcome among mothers with history of bleeding during current pregnancy was 46.1% compared to 14.2% without history of bleeding during current pregnancy. About 57.2% of mothers with history of bleeding during current pregnancy and 18.9% of mothers without history of bleeding during current pregnancy developed adverse perinatal outcome. Mothers with bleeding during pregnancy were 3.94 times more likely to develop postpartum hemorrhage (ARR = 3.94 at 95% CI (1.76, 8.83), 2.84 times more likely to undergo emergency caesarean section (ARR = 2.84 at 95% CI 2.07, 3.88), gave birth to preterm birth ARR = 3.93 at 95% CI of (2.78, 5.56), low birth weight; ARR = 4.52 at 95% CI of (3.01, 6.64) and still birth; ARR = 3.75 at 95% CI of (1.9, 7.38) compared to mothers without history of bleeding during pregnancy. Conclusion and recommendation: bleeding during pregnancy is causing higher risk of adverse maternal and perinatal outcomes. It leads to postpartum hemorrhage, emergency cesarean section, higher risk of preterm birth, low birth weight, still birth, perinatal death, low Apgar score and admission to NICU. Early identification of women at risk of antepartum hemorrhage and early management and follow-up helps to prevent adverse maternal and perinatal outcomes associated with antepartum hemorrhage.