Background
Methods
Data sources
Definitions
Statistical analysis
Results
Characteristics of study participants
Item | All women (n = 62,033) | Women with unknown HIV status (n = 5741) | HIV negative women (n = 33,099) | HIV positive women (n = 23,193) | |||||
---|---|---|---|---|---|---|---|---|---|
Total | Weighted % | Total | Weighted % | Total | Weighted % | Total | Weighted % | ||
Year of admission | 2010 | 10,526 | 20.8 | 675 | 18.4 | 4272 | 20.9 | 5579 | 24.1 |
2011 | 16,216 | 30.9 | 1647 | 38.2 | 7056 | 29.4 | 7513 | 32.4 | |
`2012 | 16,749 | 22.6 | 1888 | 23.6 | 9889 | 22.5 | 4972 | 21.4 | |
2013 | 18,542 | 25.8 | 1531 | 19.9 | 11,882 | 27.2 | 5129 | 22.1 | |
Maternal complication | None | 52,992 | 86.8 | 4674 | 82.4 | 28,932 | 88.0 | 19,386 | 83.6 |
Hemorrhage | 1566 | 2.0 | 173 | 2.9 | 621 | 1.7 | 772 | 3.3 | |
OPL | 2899 | 4.3 | 312 | 5.0 | 1413 | 4.7 | 1175 | 5.1 | |
Preeclampsia | 511 | 0.8 | 78 | 1.2 | 260 | 0.7 | 173 | 0.7 | |
Sepsis | 101 | 0.1 | 13 | 0.3 | 21 | 0.1 | 67 | 0.3 | |
RU | 161 | 0.2 | 28 | 0.5 | 68 | 0.2 | 65 | 0.3 | |
Unspecified | 3275 | 5.0 | 386 | 6.4 | 1610 | 4.7 | 1278 | 5.5 | |
Unknown | 528 | 0.7 | 77 | 1.4 | 174 | 0.5 | 277 | 1.2 | |
Infant complication | None | 51,017 | 85.8 | 4691 | 82.1 | 28,892 | 87.6 | 17,435 | 75.2 |
Prematurity | 2609 | 3.6 | 281 | 4.7 | 1163 | 3.3 | 1156 | 5.0 | |
LBW | 2166 | 3.0 | 261 | 4.8 | 844 | 2.5 | 1073 | 4.6 | |
Asphyxia | 2140 | 3.4 | 246 | 3.9 | 1158 | 3.3 | 732 | 3.2 | |
Unspecified | 1683 | 2.6 | 197 | 3.3 | 811 | 2.4 | 675 | 2.9 | |
Unknown | 2418 | 1.6 | 65 | 1.2 | 231 | 0.8 | 2122 | 9.1 | |
No of previous deliveries | 0 | 14,446 | 29.1 | 1738 | 30.6 | 10,125 | 30.8 | 2583 | 11.1 |
1 | 12,554 | 21.2 | 1138 | 19.9 | 7314 | 21.8 | 4102 | 17.7 | |
2–3 | 19,780 | 28.0 | 1505 | 26.2 | 8856 | 26.9 | 9419 | 40.6 | |
> 3 | 14,554 | 20.5 | 1180 | 20.4 | 6523 | 19.6 | 6851 | 29.5 | |
Unknown | 699 | 1.2 | 180 | 2.9 | 281 | 0.9 | 238 | 1.0 | |
Age in years | < 20 | 11,191 | 23.0 | 1428 | 26.3 | 8217 | 24.4 | 1546 | 6.7 |
20–24 | 17,485 | 31.0 | 1738 | 30.5 | 10,491 | 32.0 | 5256 | 22.7 | |
25–29 | 14,003 | 20.0 | 1035 | 17.1 | 6374 | 19.5 | 6595 | 28.4 | |
30–34 | 10,960 | 13.9 | 740 | 12.5 | 4389 | 12.9 | 58,31 | 25.1 | |
> 34 | 7288 | 10.2 | 583 | 9.8 | 3094 | 9.6 | 3610 | 15.6 | |
Unknown | 1106 | 1.9 | 217 | 4.0 | 534 | 1.6 | 355 | 1.5 | |
Singleton | Yes | 59,862 | 96.6 | 5519 | 96.1 | 32,068 | 96.7 | 22,274 | 96.0 |
No | 2171 | 3.4 | 222 | 3.9 | 1031 | 3.3 | 919 | 4.0 | |
ARVs during pregnancy | None, HIV+ | 11,938 | 4.3 | N/A | 11,938 | 51.5 | |||
<4wks | 2716 | 1.0 | 2716 | 11.7 | |||||
≥4wks | 8539 | 3.1 | 8539 | 36.8 | |||||
None, HIV- | 38,840 | 91.6 | N/A | ||||||
Facility ownership | Government | 55,583 | 89.6 | 5476 | 95.3 | 29,447 | 88.1 | 20,660 | 89.1 |
CHAM | 6450 | 10.4 | 265 | 4.7 | 3652 | 11.9 | 2533 | 10.9 | |
Facility location | Rural | 47,215 | 80.4 | 4936 | 86.2 | 26,660 | 80.8 | 15,619 | 67.3 |
Urban | 14,818 | 19.6 | 805 | 13.8 | 6439 | 19.2 | 7574 | 32.7 |
Maternal and infant complications
Mode of delivery
Item | All Women (n = 62,033) | Women with unknown HIV status (n = 5741) | HIV negative women n = 33,099) | HIV positive women n = 23,193 | |
---|---|---|---|---|---|
Year of admission | 2010 | 15.2 (14.2–16.3) | 17.2 (14.3–20.7) | 15.1 (13.9–16.4) | 13.7 (12.8–14.6) |
2011 | 13.7 (12.9–14.5) | 13.4 (11.7–15.4) | 13.8 (12.9–14.9) | 13.3 (12.5–14.1) | |
2012 | 13.4 (12.8–13.9) | 18.2 (16.6–20.1) | 12.8 (12.2–13.5) | 9.6 (8.8–10.5) | |
2013 | 13.8 (13.3–14.4) | 18.1 (16.2–20.1) | 13.5 (12.9–14.1) | 11.0 (10.2–11.9) | |
Maternal complication | None | 6.6 (6.3–6.9) | 6.3 (6.1–6.6) | 6.8 (6.6–6.9) | 5.1 (4.8–5.4) |
Hemorrhage | 29.5 (26.5–32.8) | 34.7 (32.0–37.6) | 30.2 (28.7–31.7) | 19.0 (16.4–22.0) | |
OPL | 68.2 (65.8–70.4) | 68.0 (65.9–70.0) | 69.2 (68.2–70.1) | 60.9 (58.0–63.6) | |
Preeclampsia | 60.2 (55.0–65.2) | 64.8 (60.4–69.1) | 61.2 (58.7–63.6) | 39.3 (32.3–46.8) | |
Sepsis | 16.5 (7.3–33.3) | 5.1 (2.1–11.5) | 30.7 (23.4–39.2) | 6.0 (2.2–14.9) | |
RU | 87.4 (78.5–93.0) | 84.7 (78.6–89.4) | 90.7 (87.6–93.1) | 72.3 (60.2–81.9) | |
Unspecified | 75.7 (73.5–77.8) | 77.0 (75.3–78.6) | 77.2 (76.3–78.0) | 61.4 (58.7–64.1) | |
Unknown | 33.0 (27.6–38.8) | 31.9 (28.1–36.1) | 36.6 (33.8–39.4) | 20.6 (16.2–25.8) | |
Infant complication | None | 12.4 (12.0–12.8) | 13.9 (13.5–14.3) | 12.3 (12.1–12.4) | 11.2 (10.7–11.7) |
Prematurity | 17.0 (15.1–19.1) | 21.7 (19.9–23.7) | 16.1 (15.3–17.0) | 15.2 (13.3–17.4) | |
LBW | 20.8 (18.4–23.4) | 16.1 (14.5–17.8) | 23.0 (21.9–24.1) | 18.0 (15.8–20.4) | |
Asphyxia | 29.2 (26.7–31.8) | 40.0 (37.5–42.5) | 26.8 (25.8–27.8) | 30.2 (27.0–33.6) | |
Unspecified | 32.4 (29.5–35.5) | 36.8 (34.2–39.5) | 31.8 (30.6–33.1) | 29.2 (25.9–32.7) | |
Unknown | 15.7 (12.9–19.1) | 15.5 (12.5–19.0) | 31.2 (29.1–33.4) | 2.7 (2.1–3.5) | |
No of previous deliveries | 0 | 16.3 (15.5–17.1) | 16.2 (15.5–16.9) | 16.2 (16.0–16.5) | 18.7 (17.3–20.3) |
1 | 14.2 (13.3–15.0) | 15.9 (15.1–16.8) | 14.0 (13.7–14.3) | 12.6 (11.6–13.6) | |
2–3 | 13.3 (12.6–14.0) | 17.8 (17.0–18.5) | 12.7 (12.5–13.0) | 11.6 (11.0–12.3) | |
> 3 | 11.2 (10.5–12.1) | 13.8 (13.0–14.6) | 11.0 (10.7–11.3) | 9.9 (9.2–10.6) | |
Unknown | 17.4 (14.1–21.3) | 20.2 (18.0–22.7) | 16.2 (14.6–17.9) | 14.3 (10.4–19.3) | |
Age in years | < 20 | 14.3 (13.5–15.1) | 13.3 (12.6–14.0) | 14.5 (14.2–14.8) | 13.6 (12.0–15.5) |
20–24 | 14.6 (13.9–15.4) | 18.5 (17.8–19.3) | 14.2 (13.9–14.4) | 12.3 (11.4–13.2) | |
25–29 | 14.6 (13.8–15.5) | 18.7 (17.8–19.6) | 14.4 (14.1–14.7) | 11.8 (11.1–12.6) | |
30–34 | 12.1 (11.2–13.0) | 13.7 (12.8–14.7) | 11.8 (11.4–12.2) | 11.9 (11.1–12.8) | |
> 34 | 12.6 (11.5–13.8) | 15.3 (14.2–16.5) | 12.2 (11.8–12.7) | 11.9 (10.9–13.0) | |
Unknown | 13.6 (11.1–16.4) | 15.3 (13.6–17.3) | 13.0 (11.9–14.1) | 12.4 (9.3–16.3) | |
Singleton | Yes | 13.7 (13.4–14.1) | 16.0 (15.7–16.4) | 13.6 (13.4–13.7) | 11.7 (11.3–12.2) |
No | 20.4 (17.9–23.0) | 19.7 (17.8–21.8) | 20.4 (19.5–21.4) | 20.8 (18.2–23.4) | |
ARVs during pregnancy | None | 11.7 (11.1–12.3) | N/A | 11.7 (11.1–12.3) | |
<4wks | 12.4 (11.3–13.7) | 12.4 (11.3–13.7) | |||
≥4wks | 12.5 (11.9–13.2) | 12.5 (11.9–13.3) | |||
HIV- & Unknown | 14.1 (13.7–14.6) | N/A | |||
Facility ownership | Government | 13.8 (13.4–14.2) | 16.2 (15.8–16.5) | 13.5 (13.4–13.7) | 12.2 (11.8–12.7) |
CHAM | 15.3 (14.1–16.7) | 16.6 (15.0–18.4) | 15.7 (15.2–16.1) | 11.3 (10.1–12.5) | |
Facility location | Rural | 13.6 (13.4–13.7) | 16.0 (15.6–16.4) | 13.3 (13.1–13.4) | 11.4 (10.9–11.9) |
Urban | 15.7 (15.4–16.0) | 17.3 (16.3–18.3) | 15.9 (15.5–16.2) | 13.6 (12.9–14.4) | |
Totals | 14.0 (13.6–14.4) | 16.2 (15.1–17.3) | 13.8 (13.3–14.2) | 12.1 (9.1–15.1) |
Associations of individual and facility level characteristics with CS
Item | aOR (95% CI) All Women (55,443) |
p
| aOR (95% CI) Women with Unknown HIV status (n = 5302) |
P
| aOR (95% CI) HIV- Women (n = 31,978) |
p
| aOR (95% CI) HIV+ Women (n = 20,436) |
P
| |
---|---|---|---|---|---|---|---|---|---|
Year of admission | 2010 | 1 | 0.07 | 1 | 0.09 | 1 | 0.02 | 1 | 0.06 |
2011 | 0.71 (0.50–1.01) | 0.58 (0.37–0.91) | 0.71 (0.50–1.00) | 1.00 (0.73–1.38) | |||||
2012 | 0.65 (0.45–0.93) | 0.71 (0.42–1.19) | 0.61 (0.43–0.88) | 0.83 (0.56–1.22) | |||||
2013 | 0.67 (0.49–0.92) | 0.67 (0.43–1.07) | 0.65 (0.48–0.87) | 1.04 (0.73–1.49) | |||||
Maternal Obstetric Complication | None | 1 | < 0.01 | 1 | < 0.01 | 1 | < 0.01 | 1 | < 0.01 |
Hemorrhage | 5.85 (3.12–10.97) | 7.02 (4.26–11.58) | 5.80 (3.03–11.12) | 4.25 (1.72–10.47) | |||||
OPL | 32.23 (17.15–60.57) | 29.43 (17.75–48.80) | 33.61 (16.99–66.47) | 29.88 (11.89–75.13) | |||||
Preeclampsia | 21.76 (10.32–45.86) | 27.18 (14.18–52.09) | 22.14 (9.83–49.88) | 11.23 (4.56–27.68) | |||||
Sepsis | 4.25 (1.30–13.85) | 1.35 (0.14–13.18) | 8.13 (1.57–42.16) | 1.20 (0.36–4.02) | |||||
RU | 160.25 (75.41–340.51) | 141.95 (34.98–576.08) | 186.48 (66.45–523.27) | 94.91 (43.33–207.89) | |||||
Others | 52.85 (31.25–89.39) | 51.75 (35.26–75.97) | 55.-81 (33.24–93.69) | 38.01 (15.13–95.52) | |||||
Infant Complication | None | 1 | 0.01 | 1 | < 0.01 | 1 | < 0.01 | 1 | < 0.01 |
Prematurity | 0.99 (0.77–1.29) | 1.12 (0.61–2.05) | 0.95 (0.61–1.46) | 1.11 (0.87–1.42) | |||||
LBW | 1.40 (1.07–1.83) | 0.77 (0.38–1.58) | 1.75 (1.28–2.39) | 1.09 (0.77–1.53) | |||||
Asphyxia | 1.86 (1.29–2.67) | 3.02 (1.83–4.96) | 1.65 (1.08–2.53) | 1.92 (1.33–2.76) | |||||
Others | 1.59 (1.15–2.19) | 2.20 (1.07–4.52) | 1.53 (1.10–2.11) | 1.14 (0.73–1.78) | |||||
No of previous deliveries | 0 | 1 | < 0.01 | 1 | 0.31 | 1 | < 0.01 | 1 | < 0.01 |
1 | 0.83 (0.74–0.93) | 0.84 (0.63–1.12) | 0.84 (0.74–0.95) | 0.61 (0.49–0.76) | |||||
2–3 | 0.68 (0.56–0.83) | 0.79 (0.55–1.13) | 0.68 (0.55–0.84) | 0.50 (0.40–0.62) | |||||
> 3 | 0.52 (0.41–0.66) | 0.72 (0.50–1.05) | 0.51 (0.39–0.67) | 0.35 (0.26–0.45) | |||||
Age (years) | < 20 | 1 | < 0.01 | 1 | 0.02 | 1 | 0.01 | 1 | < 0.01 |
20–24 | 1.28 (1.12–1.47) | 1.75 (1.25–2.44) | 1.20 (1.04–1.39) | 1.37 (1.12–1.67) | |||||
25–29 | 1.56 (1.27–1.93) | 1.96 (1.23–3.11) | 1.49 (1.16–1.92) | 1.72 (1.34–2.21) | |||||
30–34 | 1.44 (1.15–1.81) | 1.66 (0.99–2.78) | 1.35 (1.03–1.78) | 1.98 (1.50–2.61) | |||||
> 34 | 1.63 (1.34–1.99) | 1.62 (1.00–2.64) | 1.57 (1.21–2.03) | 2.24 (1.75–2.85) | |||||
Singletons | Yes | 1 | < 0.01 | 1 | 0.35 | 1 | 0.03 | 1 | 0.04 |
No | 1.49 (1.10–2.03) | 1.31 (0.74–2.33) | 1.51 (1.05–2.16) | 1.58 (1.03–2.43) | |||||
ARVs during Pregnancy | None | N/A | N/A | N/A | 1 | 0.83 | |||
<4wks | N/A | N/A | N/A | 0.98 (0.72–1.32) | |||||
≥4wks | N/A | N/A | N/A | 0.96 (0.81–1.12) | |||||
Facility Ownership | Govt. | 1 | 0.90 | 1 | 0.57 | 1 | 0.36 | 1 | 0.77 |
CHAM | 1.42 (0.65–3.13) | 1.27 (0.55–2.94) | 1.48 (0.64–3.41) | 1.09 (0.62–1.90) | |||||
Facility Location | Rural | 1 | 0.27 | 1 | 0.26 | 1 | 0.13 | 1 | 0.23 |
Urban | 1.39 (0.91–2.12) | 1.19 (0.88–1.62) | 1.47 (0.89–2.41) | 1.16 (0.91–1.46) |
Associations of individual and facility level characteristics with ECS
Item | aOR (95% CI) All Women (55,443) |
p
| aOR (95% CI) Women with Unknown HIV status (n = 4764) |
p
| aOR (95% CI) HIV- Women (n = 29,747) |
p
| aOR (95% CI) HIV+ Women (n = 20,932) |
p
| |
---|---|---|---|---|---|---|---|---|---|
Year of Admission | 2010 | 1 | 0.03 | 1 | 0.01 | 1 | 0.02 | 1 | < 0.09 |
2011 | 0.63 (0.42–0.94) | 0.47 (0.29–0.76) | 0.64 (0.43–0.96) | 0.84 (0.55–1.30) | |||||
2012 | 0.55 (0.34–0.88) | 0.61 (0.31–1.22) | 0.53 (0.33–0.86) | 0.55 (0.28–1.06) | |||||
2013 | 0.53 (0.35–0.83) | 0.40 (0.21–0.78) | 0.54 (0.36–0.82) | 0.68 (0.39–1.19) | |||||
No of deliveries | 0 | 1 | < 0.01 | 1 | 0.11 | 1 | < 0.01 | 1 | < 0.01 |
1 | 0.76 (0.66–0.87) | 0.74 (0.57–0.96) | 0.77 (0.66–0.90) | 0.59 (0.46–0.75) | |||||
2–3 | 0.65 (0.51–0.82) | 0.68 (0.42–1.11) | 0.65 (0.51–0.83) | 0.49 (0.38–0.63) | |||||
> 3 | 0.46 (0.34–0.63) | 0.68 (0.40–1.16) | 0.45 (0.31–0.65) | 0.31 (0.22–0.43) | |||||
Age (years) | < 20 | 1 | < 0.01 | 1 | < 0.01 | 1 | < 0.01 | 1 | < 0.01 |
20–24 | 1.38 (1.18–1.61) | 2.07 (1.42–3.03) | 1.29 (1.09–1.53) | 1.46 (1.12–1.91) | |||||
25–29 | 1.68 (1.35–2.09) | 2.11 (1.21–3.67) | 1.60 (1.25–2.06) | 1.86 (1.33–2.60) | |||||
30–34 | 1.46 (1.10–1.92) | 1.44 (0.81–2.54) | 1.37 (1.00–1.88) | 2.19 (1.40–3.43) | |||||
> 34 | 1.68 (1.24–2.27) | 1.93 (1.07–3.50) | 1.58 (1.08–2.32) | 2.26 (1.57–3.27) | |||||
Singletons | Yes | 1 | < 0.01 | 1 | 0.13 | 1 | < 0.01 | 1 | < 0.01 |
No | 1.98 (1.55–2.54) | 1.48 (0.90–2.46) | 2.06 (1.54–2.77) | 2.27 (1.51–3.41) | |||||
ARVs during Pregnancy | None | N/A | N/A | N/A | 1 | 0.04 | |||
<4wks | N/A | N/A | N/A | 0.96 (0.73–1.27) | |||||
≥4wks | N/A | N/A | N/A | 0.81 (0.68–0.96) | |||||
Facility Ownership | Government | 1 | 0.69 | 1 | 0.47 | 1 | 0.72 | 1 | 0.80 |
CHAM | 1.63 (0.69–3.83 | 1.19 (0.74–1.91) | 1.75 (0.72–4.27) | 1.08 (0.59–1.99) | |||||
Facility Location | Rural | 1 | 0.03 | 1 | 0.01 | 1 | 0.03 | 1 | < 0.01 |
Urban | 1.95 (1.06–3.56) | 1.52 (1.17–1.98) | 2.02 (1.05–3.86) | 2.15 (1.27–3.64) |