Injury patterns and health outcomes among pregnant women seeking emergency medical care in Kumasi, Ghana: Challenges and opportunities to improve care

详细信息    查看全文

• 作者：Maxwell Osei-Ampofo^a ; ^{maxwelloseiampofo@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Katherine T. Flynn-O&rsquo ; Brien^b ; ^c ; ^d ; Ellis Owusu-Dabo^e ; ^f ; Easmon Otupiri^f ; George Oduro^a ; Peter Donkor^g ; ^h ; Charles Mock^b ; ^c ; ^d ; Beth E. Ebel^b ; ⁱ ; ^j
• 关键词：Ghana ; Pregnancy ; Maternal health outcome ; Injury ; Intimate partner violence ; Emergency medical care
• 刊名：African Journal of Emergency Medicine
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：6
• 期：2
• 页码：87-93
• 全文大小：346 K

文摘

In high-income countries, injury is the most common cause of non-obstetric death among pregnant women. However, the injury risk during pregnancy has not been well characterized for many developing countries including Ghana. Our study described maternal and fetal outcomes after injury at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, and identified associations between the prevalence of poor outcomes and maternal risk factors.

Methods

We conducted a cross-sectional study to identify pregnant women treated for injury over a 12-month period at KATH in Kumasi, Ghana. Descriptive statistics were used to characterize the population. We identified the association between poor outcomes and maternal risk factors using multivariable Poisson regression.

Results

There were 134 women with documented pregnancy who sought emergency care for injury (1.1% of all injured women). The leading injury mechanisms were motor vehicle collision (23%), poisoning (21%), and fall (19%). Assault was implicated in 3% of the injuries. Eleven women (8%) died from their injuries. The prevalence of poor fetal outcomes: fetal death, distress or premature birth, was high (61.9%). One in four infants was delivered prematurely following maternal injury. After adjusting for maternal and injury characteristics, poor fetal outcomes were associated with pedestrian injury (adjusted prevalence ratio (aPR) 2.5, 95% CI 1.5–4.6), and injury to the thoraco-abdominal region (aPR 2.1, 95% CI 1.4–3.3).

Conclusions

Injury is an important cause of maternal morbidity and poor fetal outcomes. Poisoning, often in an attempt to terminate pregnancy, was a common occurrence among pregnant women treated for injury in Kumasi. Future work should address modifiable risk factors related to traffic safety, prevention of intimate partner violence, and prevention of unintended pregnancies.