Postpartum length of hospital stay among obstetric patients in Ibadan, Nigeria.

ABSTRACT

BACKGROUND: Postpartum Length of hospital stay (PLOHS) is an essential indicator of the quality of maternal and perinatal healthcare services. Identifying the factors associated with PLOHS will inform targeted interventions to reduce unnecessary hospitalisations and improve patient outcomes after childbirth. Therefore, we assessed the length of hospital stay after birth and the associated factors in Ibadan, Nigeria. METHODS: We used the Ibadan Pregnancy Cohort Study (IbPCS) data, and examined the 1057 women who had information on PLOHS the mode of delivery [spontaneous vagina delivery (SVD) or caesarean section (C/S)]. The outcome variable was PLOHS, which was described as the time interval between the delivery of the infant and discharge from the health facility. PLOHS was prolonged if > 24 h for SVD and > 96 h for C/S, but normal if otherwise. Data were analysed using descriptive statistics, a chi-square test, and modified Poisson regression. The prevalence-risk ratio (PR) and 95% confidence interval (CI) are presented at the 5% significance level. RESULTS: The mean maternal age was (30.0 ± 5.2) years. Overall, the mean PLOHS for the study population was 2.6 (95% CI 2.4-2.7) days. The average PLOHS for women who had vaginal deliveries was 1.7 (95%CI 1.5-1.9) days, whereas those who had caesarean deliveries had an average LOHS of 4.4 (95%CI 4.1-4.6) days. About a third had prolonged PLOHS SVD 229 (32.1%) and C/S 108 (31.5%). Factors associated with prolonged PLOHS with SVD, were high income (aPR = 1.77; CI 1.13, 2.79), frequent ANC visits (> 4) (aPR = 2.26; CI 1.32, 3.87), and antenatal admission (aPR = 1.88; CI 1.15, 3.07). For C/S maternal age > 35 years (aPR = 1.59; CI 1.02, 2.47) and hypertensive disease in pregnancy (aPR = 0.61 ; CI 0.38, 0.99) were associated with prolonged PLOHS. CONCLUSION: The prolonged postpartum length of hospital stay was common among our study participants occurring in about a third of the women irrespective of the mode of delivery. Maternal income, advanced maternal age, ANC related issues were predisposing factors for prolonged LOHS. Further research is required to examine providers' perspectives on PLOHS among obstetric patients in our setting.