Determinants of Prolonged Maternal Hospital Stay Post-delivery in a Teaching Hospital in Accra, Ghana

Abstract

Background: Maternal care refers to the care provided to patients during the perinatal period. According to the World Health Organization (WHO), all women should remain admitted for at least 24 hours after birth. However, there is no consensus on the appropriate length of stay (LOS). Aim: To determine the length of stay among mothers post-delivery and associated factors at the Korle-Bu Teaching Hospital. Method: The study was an observational retrospective study. Mothers totaling 2142 were included. Data were coded, cleaned in Windows Excel 2016, and analyzed using Stata IC (Version 17.0). Variables with missing values of more than 5% were excluded from the regression analysis. Continuous and categorical variables were summarized using means and frequency distribution, respectively. The chi-square test was used to test the association between categorical variables. Bivariate and multivariate logistic regression analyses were done to determine the strength of association between the dependent and independent variables. Results: The proportion of women with and increased Los was 966 (45%). Age was not significantly associated with increased or longer LOS (AOR=1.10, 95% CI=0.98-1.03, P=0.68). Women with gravidity 3 had a lower risk of longer LOS compared to those with one pregnancy (AOR=0.55, 95% CI=0.38-0.74, P=0.002). Married and cohabiting women had a lower risk of longer LOS compared to single women [(AOR=0.54, 95% CI=0.34- 0.88, P=0.01; AOR=0.41, 95% CI=0.27-0.64, P=0.001, respectively)]. Women with secondary education had a higher risk of longer LOS compared to those with no education (AOR=2.53, 95% CI=1.55-4.12). Women who had caesarean section were highly significantly more likely to experienced prolonged LOS (AOR=12.95, 95% CI=10.04-16.71). Conclusion: Healthcare providers should work towards improving the quality of maternal care, particularly for patients who are at a higher risk of longer LOS.