Assessment and Comparison of Obstetric Characteristics and Perinatal Outcomes of Rural Population of South Africa

Context : Maternal and perinatal morbidity and mortality are the major health problems confronting many developing countries including South Africa. In developing countries, interventions that are known to be effective in lowering maternal and perinatal mortality and morbidity are not universally provided. In the past, access to maternal health services was a major problem for rural and black communities of SA. Objective : The objectives were to assess and compare the demographic and obstetric characteristics and perinatal outcome indicators over time. Study design, Setting and Subjects : A retrospective comparative study was conducted for women delivered during 1999 (3875) and 2004 (3912) at a rural Empangeni hospital. Multivariate logistic regression was undertaken to determine the significant predictors for outcome variables. Results : The prevalence of teenage pregnancy and pregnancy of younger women (<25 years) were increased significantly by 3% and 8% respectively (p < 0.05). There was a significant reduction of pregnancies among higher parity (parity 5 or more) women during 2004 (p < 0.05). There were significant reductions of eclampsia, anaemia, and post partum  haemorrhage during delivery for the year 2004. Breech presentation was 3.75 times more likely to deliver preterm and 5.45 times more likely to deliver low birth weight babies. Pregnancy induced hypertension was more likely to have preterm (OR =3.50) and low birth weight babies (OR = 2.09). Eclampsia was also a risk factor for preterm (OR = 6.14), and low birth weight babies (OR = 18.42). Conclusion : Further research is needed to find the causes of higher rate of teenage pregnancies and simple strategies to combat high rates of negative perinatal outcomes. Key Words : Pregnancy Complications, Outcome, Rural Healthcare