|
Adverse maternal outcomes
|
WHOGS
|
WHOMCS
|
Combined
|
|---|
|
n/N (%)
|
Crude ORa (95% CI)
|
AORb (95% CI)
|
n/N (%)
|
Crude ORa (95% CI)
|
AOR* (95% CI)
|
n/N (%)
|
Crude ORa (95% CI)
|
AORb (95% CI)
|
|---|
|
PPH
|
|
IOL
|
88/2119 (4.2)
|
1
|
1
|
38/2213 (1.7)
|
1
|
1
|
126/4332 (2.9)
|
1
|
1
|
|
ECS
|
11/691 (1.6)
|
0.78 (0.39, 1.56)
|
0.66 (0.30, 1.44)
|
19 /1260 (1.5)
|
1.01 (0.54, 1.87)
|
0.99 (0.50, 1.98)
|
30 /1951 (1.5)
|
1.01 (0.66, 1.53)
|
0.89 (0.56, 1.43)
|
|
EM
|
542/13338 (4.1)
|
1.12 (0.84, 1.51)
|
1.21 (0.86, 1.70)
|
173/13382 (1.3)
|
0.88 (0.58, 1.33)
|
0.91 (0.57, 1.45)
|
715/26720 (2.7)
|
1.03 (0.82, 1.29)
|
1.03 (0.80, 1.33)
|
|
Ruptured uterus
|
|
IOL
|
3/2119 (0.5)
|
1
|
1
|
0/2213 (0.0)
|
–
|
–
|
3/4332 (0.1)
|
1
|
1
|
|
ECS
|
2/691 (0.3)
|
0.65 (0.10, 4.04)
|
0.40 (0.05, 3.22)
|
0 /1260 (0.0)
|
–
|
–
|
2 /1951 (0.1)
|
0.74 (0.15, 3.60)
|
0.48 (0.07, 3.05)
|
|
EM
|
40/13338 (1.2)
|
2.70 (0.79, 9.28)
|
1.52 (0.32, 7.16)
|
10/13382 (0.1)
|
–
|
–
|
50/26720 (0.3)
|
3.29 (1.16, 9.33)
|
1.98 (0.51, 7.65)
|
|
Admission to ICU
|
|
IOL
|
24/2119 (1.1)
|
1
|
1
|
0/2213 (0.0)
|
–
|
–
|
24/4332 (0.6)
|
1
|
1
|
|
ECS
|
5/691 (0.7)
|
1.85 (0.58, 5.88)
|
1.17 (0.35, 4.03)
|
0 /1260 (0.0)
|
–
|
–
|
5 /1951 (0.3)
|
1.21 (0.49, 2.96)
|
1.09 (0.36, 3.31)
|
|
EM
|
258/13338 (1.9)
|
0.62 (0.37, 1.03)
|
0.60 (0.34, 1.03)
|
8/13382 (0.1)
|
–
|
–
|
266/26720 (1.0)
|
0.69 (0.44, 1.07)
|
0.66 (0.39, 1.13)
|
|
Postpartum length of stay >7 days
|
|
IOL
|
76/2119 (3.6)
|
1
|
1
|
44/2213 (2.0)
|
1
|
1
|
120/4332 (2.8)
|
1
|
1
|
|
ECS
|
21/691 (3.0)
|
2.18 (1.29, 3.68)
|
1.22 (0.68, 2.19)
|
49 /1260 (3.9)
|
2.33 (1.51, 3.60)
|
1.54 (0.96, 2.49)
|
70 /1951 (3.6)
|
2.16 (1.57, 2.99)
|
1.33 (0.93, 1.90)
|
|
EM
|
373/13338 (2.8)
|
1.08 (0.80, 1.45)
|
0.98 (0.71, 1.35)
|
424/13382 (3.2)
|
0.81 (0.57, 1.15)
|
0.83 (0.57, 1.21)
|
797/26720 (3.0)
|
0.91 (0.73, 1.13)
|
0.87 (0.69, 1.11)
|
|
Severe maternal outcomec
|
|
IOL
|
52/2119 (2.5)
|
1
|
1
|
4/2213 (0.2)
|
1
|
1
|
56/4332 (1.3)
|
1
|
1
|
|
ECS
|
14/691 (2.0)
|
1.41 (0.73, 2.70)
|
1.15 (0.57, 2.34)
|
3 /1260 (0.2)
|
1.41 (0.30, 6.63)
|
0.64 (0.10, 3.97)
|
17 /1951 (0.9)
|
1.42 (0.83, 2.46)
|
1.08 (0.59, 1.96)
|
|
EM
|
382/13338 (2.9)
|
0.80 (0.56, 1.14)
|
0.86 (0.59, 1.27)
|
18/13382 (0.1)
|
0.67 (0.21, 2.13)
|
0.55(0.16, 1.79)
|
400/26720 (1.5)
|
0.77 (0.56, 1.04)
|
0.80 (0.57, 1.13)
|
|
CS rate
|
|
IOL
|
590/2119 (27.8)
|
1
|
1
|
690/2213 (31.2)
|
1
|
1
|
1280/4332 (29.6)
|
1
|
1
|
|
EM
|
3416/13338 (25.6)
|
0.82 (0.73, 0.92)
|
0.76 (0.66,0.87)
|
3463/13382 (25.9)
|
0.69 (0.61, 0.77)
|
0.67 (0.59,0.76)
|
6879/26720 (25.7)
|
0.74 (0.68, 0.80)
|
0.70 (0.64,0.77)
|
- (IOL Induction of labour group, ECS Elective Caesarean section group, EM Expectant management group) aCrude ORs were calculated by multilevel logistic regression model after accounted for cluster effect (facility level and country level) bAdjusted – for maternal characteristics (age, marital status, education, parity, previous CS); neonatal characteristics (birth weight); facility capacity index score and cluster effect (health facility level, country level in WHOGS and WHOMCS; one more level (data source – WHOGS & WHOMCS) in combined database cSevere maternal outcome – presence of at least one of maternal death, blood transfusion, hysterectomy, eclampsia and admission to ICU in WHOGS; presence of maternal death or maternal near miss in WHOMCS (Maternal near miss is defined as WHO criteria)Values in bold mean they are statistically significant (p < 0.05)
