Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort study
Abstract Background Antepartum hemorrhage (APH) complicates 2–5% of all pregnancies and is the main cause of fetal and maternal death. However, little is known about the adverse maternal and perinatal outcomes of antepartum hemorrhage in the Tigray region. Therefore, this study assessed the effects...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12884-025-07829-0 |
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| author | Mamit Gebreslassie Gebrekidan Meseret Abay Fisseha Aregawi Gebreyesus Belay Girmatsion Fisseha Abreha |
| author_facet | Mamit Gebreslassie Gebrekidan Meseret Abay Fisseha Aregawi Gebreyesus Belay Girmatsion Fisseha Abreha |
| author_sort | Mamit Gebreslassie Gebrekidan |
| collection | DOAJ |
| description | Abstract Background Antepartum hemorrhage (APH) complicates 2–5% of all pregnancies and is the main cause of fetal and maternal death. However, little is known about the adverse maternal and perinatal outcomes of antepartum hemorrhage in the Tigray region. Therefore, this study assessed the effects of antepartum hemorrhage on maternal and perinatal adverse outcomes at Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia, in 2024. Methods An institutional-based retrospective cohort study was conducted among 539 mothers who gave birth between September 2019 and August 2021 at Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia. Mothers who gave birth with and without antepartum hemorrhage were categorized as exposed and nonexposed groups, respectively. A systematic sampling method was used to select participants from medical records. Data were collected through a retrospective review of medical records. A modified Poison regression model with robust standard errors was used to estimate relative risk (RR). An adjusted relative risk (ARR) with 95% confidence interval (CI) and a p-value < 0.05 were considered statistically significant. Results The incidence of adverse maternal outcomes among mothers with antepartum hemorrhage was 46.1%, compared to 14.2% among mothers without APH. Approximately 57.2% of mothers with APH and 18.9% of those without APH experienced adverse perinatal outcomes. Mothers with antepartum hemorrhage were more likely to experience postpartum hemorrhage (ARR = 3.9, 95% CI: 1.8, 8.8), emergency cesarean section (ARR = 2.9, 95% CI: 2.1, 3.9), preterm birth (ARR = 3.9, 95%CI: 2.8, 5.6), low birth weight baby (ARR = 4.5, 95%CI: 3.0, 6.6), stillbirth (ARR = 3.8, 95%CI: 1.9, 7.4), perinatal death (ARR = 3.7, 95%CI: 2.0, 6.9), admission to the NICU (ARR = 6.7, 95% CI: 3.1, 14.9), low Apgar score at the first minute (ARR = 2.8, 95%CI: 1.8, 4.3), and low Apgar score at the fifth minute (ARR = 3.7, 95% CI: 2.0, 6.8) compared to mothers without APH. Conclusion Antepartum hemorrhage is associated with an increased risk of adverse maternal and perinatal outcomes; -including postpartum hemorrhage, emergency cesarean section, preterm birth, low birth weight, stillbirth, perinatal death, a low Apgar score and admission to the NICU. Improving access to emergency obstetric care in areas with a high burden of APH should be critical to ensure timely intervention and reduce adverse maternal and perinatal outcomes. |
| format | Article |
| id | doaj-art-b0bc53572def4febbcd78695b70ee44c |
| institution | DOAJ |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-07-01 |
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| spelling | doaj-art-b0bc53572def4febbcd78695b70ee44c2025-08-20T03:06:41ZengBMCBMC Pregnancy and Childbirth1471-23932025-07-0125111110.1186/s12884-025-07829-0Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort studyMamit Gebreslassie Gebrekidan0Meseret Abay Fisseha1Aregawi Gebreyesus Belay2Girmatsion Fisseha Abreha3Department of Reproductive Health, School of Public Health, College of Health Science, Mekelle UniversityDepartment of Reproductive Health, School of Public Health, College of Health Science, Mekelle UniversityDepartment of Epidemiology, School of Public Health, College of Health Science, Mekelle UniversityDepartment of Reproductive Health, School of Public Health, College of Health Science, Mekelle UniversityAbstract Background Antepartum hemorrhage (APH) complicates 2–5% of all pregnancies and is the main cause of fetal and maternal death. However, little is known about the adverse maternal and perinatal outcomes of antepartum hemorrhage in the Tigray region. Therefore, this study assessed the effects of antepartum hemorrhage on maternal and perinatal adverse outcomes at Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia, in 2024. Methods An institutional-based retrospective cohort study was conducted among 539 mothers who gave birth between September 2019 and August 2021 at Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia. Mothers who gave birth with and without antepartum hemorrhage were categorized as exposed and nonexposed groups, respectively. A systematic sampling method was used to select participants from medical records. Data were collected through a retrospective review of medical records. A modified Poison regression model with robust standard errors was used to estimate relative risk (RR). An adjusted relative risk (ARR) with 95% confidence interval (CI) and a p-value < 0.05 were considered statistically significant. Results The incidence of adverse maternal outcomes among mothers with antepartum hemorrhage was 46.1%, compared to 14.2% among mothers without APH. Approximately 57.2% of mothers with APH and 18.9% of those without APH experienced adverse perinatal outcomes. Mothers with antepartum hemorrhage were more likely to experience postpartum hemorrhage (ARR = 3.9, 95% CI: 1.8, 8.8), emergency cesarean section (ARR = 2.9, 95% CI: 2.1, 3.9), preterm birth (ARR = 3.9, 95%CI: 2.8, 5.6), low birth weight baby (ARR = 4.5, 95%CI: 3.0, 6.6), stillbirth (ARR = 3.8, 95%CI: 1.9, 7.4), perinatal death (ARR = 3.7, 95%CI: 2.0, 6.9), admission to the NICU (ARR = 6.7, 95% CI: 3.1, 14.9), low Apgar score at the first minute (ARR = 2.8, 95%CI: 1.8, 4.3), and low Apgar score at the fifth minute (ARR = 3.7, 95% CI: 2.0, 6.8) compared to mothers without APH. Conclusion Antepartum hemorrhage is associated with an increased risk of adverse maternal and perinatal outcomes; -including postpartum hemorrhage, emergency cesarean section, preterm birth, low birth weight, stillbirth, perinatal death, a low Apgar score and admission to the NICU. Improving access to emergency obstetric care in areas with a high burden of APH should be critical to ensure timely intervention and reduce adverse maternal and perinatal outcomes.https://doi.org/10.1186/s12884-025-07829-0Antepartum hemorrhageMaternalPerinatal adverse outcomesMekelleEthiopia |
| spellingShingle | Mamit Gebreslassie Gebrekidan Meseret Abay Fisseha Aregawi Gebreyesus Belay Girmatsion Fisseha Abreha Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort study BMC Pregnancy and Childbirth Antepartum hemorrhage Maternal Perinatal adverse outcomes Mekelle Ethiopia |
| title | Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort study |
| title_full | Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort study |
| title_fullStr | Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort study |
| title_full_unstemmed | Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort study |
| title_short | Effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in Northern Ethiopia: a retrospective cohort study |
| title_sort | effects of antepartum hemorrhage on maternal and perinatal adverse outcomes in northern ethiopia a retrospective cohort study |
| topic | Antepartum hemorrhage Maternal Perinatal adverse outcomes Mekelle Ethiopia |
| url | https://doi.org/10.1186/s12884-025-07829-0 |
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