Prevalence of non-reassuring fetal heart rate patterns and associated factors among labouring mothers at public hospitals in Wolaita Zone, Southern Ethiopia, 2024: A cross-sectional study

Abstract

BACKGROUND: Non-reassuring fetal heart rate patterns are critical indicators of potential adverse outcomes for the fetus during pregnancy. Early detection and identification of predictors are essential for reducing preventable neonatal mortality. Despite being one of the leading causes of neonatal death, there is limited evidence regarding the prevalence and predictors of non-reassuring fetal heart rate patterns in Ethiopia. OBJECTIVE: This study aims to assess the prevalence of non-reassuring fetal heart rate patterns and the associated factors among labouring mothers in public hospitals within the Wolaita Zone of Southern Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 334 labouring mothers in public hospitals within the Wolaita Zone from 1 to 30 July 2024. Study participants were selected using a systematic random sampling technique. Data were collected through interviewer-administered questionnaires and chart reviews. The collected data were entered into EpiData version 4.6 and subsequently exported to SPSS V.26 for analysis. Bivariate and multivariable logistic regression analyses were conducted to identify factors associated with the outcome variable. In the multivariable logistic regression analysis, adjusted ORs (AORs) with 95% CIs were reported, and a p-value of <0.05 was considered statistically significant. RESULTS: The prevalence of non-reassuring fetal heart rate patterns was 19.2% (95% CI 15.0 to 23.9). Labour augmentation (AOR 3.28, 95% CI 1.72 to 6.27), referred from other healthcare facilities (AOR 3.39, 95% CI 1.70 to 6.76), primigravida (AOR 2.00, 95% CI 1.07 to 3.74) and meconium-stained amniotic fluid (AOR 4.52, 95% CI 2.10 to 9.75) were significantly associated with non-reassuring fetal heart rate patterns. CONCLUSION: The prevalence of non-reassuring fetal heart rate patterns was found to be high. Consequently, it is essential to enhance intrapartum monitoring and prompt management of these risk factors, particularly among primigravida women and mothers transferred from other healthcare institutions to reduce the risk of adverse fetal outcomes.