Adverse Pregnancy Outcomes: A Cross-sectional Study of Prevalence and Associated Factors among Women Who Delivered at a Regional Hospital in Afghanistan.

Background: Previous studies have pointed out that adverse pregnancy outcomes (APOs) are major contributing causes of maternal and neonatal mortality and morbidity. However, despite Afghanistan's high maternal and neonatal mortality rates, research related to APOs is limited. Objectives: This study aimed to assess the prevalence and associated factors of APOs among women who gave birth at a regional hospital in Afghanistan. Methods: This hospital-based cross-sectional study was carried out over a three-month period at the obstetrics and gynecology ward of Mirwais Regional Hospital (MRH) in Kandahar, Afghanistan. We used a composite measure as our outcome variable (APOs), which comprised both maternal and fetal/neonatal adverse outcomes. Factors associated with APOs were determined using bivariate and multivariable logistic regression models. Results: The overall prevalence of APOs was 45% (95%CI [40.1-49.75%]). Maternal adverse outcomes occurred in 36.8% of cases, while fetal or neonatal adverse outcomes were seen in 15.8%. In multivariable logistic regression analysis, rural residence (Adjusted Odds Ratio [AOR]= 2.42, 95%CI [1.39-4.23]), non-use of antenatal care (ANC) (4.62 [2.18-9.76]), birth interval less than a year (2.36 [1.02-5.46]), self-medication (5.05 [2.32-11.2]), and depression symptoms (1.77 [1.01-3.14]) were significantly associated with APOs. Conclusion: This study provides essential information for clinicians and policymakers. Although not nationally representative, this study indicates a high prevalence of APOs among Afghan women. Several factors were associated with the high prevalence of APOs. The results suggest an urgent need for targeted strategies aimed at preventing and managing APOs in Afghanistan.