Adverse Birth Outcomes and Associated Factors among Iron-Folic Acid Supplements User and Non-user Women in Public Hospitals, Harari Region, Eastern, Ethiopia: A Comparative Cross-Sectional Study

Abstract

Background: Iron folic acid supplementation is a routine component of prenatal care that is an effective strategy for preventing adverse birth outcomes. However, its relationship with adverse birth outcomes is poorly understood, particularly in developing countries such as Ethiopia. Therefore, this study aimed to determine adverse birth outcomes and associated factors among iron-folic acid supplement users and non-user women in public hospitals in Eastern Ethiopia.

Methods: A comparative cross-sectional study was conducted on 512 (341 iron folic acid users and 171 non-users) consecutively selected women who gave birth in two public hospitals in the Harari region. Data were collected through interviews and complemented by reviewing medical records. Data was analyzed using the statistical package for social science version 24. Factors associated with adverse birth outcomes were identified using the multivariable binary logistic regression model. A P-value less than 0.05 is taken as a cut-off to determine statistical significance.

Results: The adverse birth outcomes among non-iron folic acid users and users were 53% (95% CI: 45.0, 61.0) and 16% (95% CI: 12.0, 20.0), respectively. Oligohydramnios (AOR=5.76; 95%CI: 1.56,21.25), spontaneous onset of labor (AOR=0.06; 95%CI: 0.04, 0.68), and induction of labor (AOR=0.20, 95%CI 0.05-0.90) were adverse birth outcomes among iron folic acid users, whereas anemia (AOR=3.38; 95%CI: 1.43, 7.98), pregnancy-induced hypertension (AOR=4.50; 95%CI: 1.61, 12.58), and maternal long working hours (AOR=1.27; 95%CI: 1.07, 1.50) were associated with adverse birth outcomes among non-iron folic acid users.

Conclusions: In this study, adverse birth outcomes are higher among non-iron folic acid users. Anemia, pregnancy-induced hypertension, and long working hours were significant associations with adverse birth outcomes among non-iron folic acid users.  Early screening and treatment of pregnancy-related complications and health education regarding iron-folic acid supplements during antenatal care should be strengthened.