Pregnancy Outcome among Nulliparous Women at the University of Maiduguri Teaching Hospital, North Eastern Nigeria: A Retrospective Cohort Study

Aim: To compare the pregnancy outcomes among nulliparae, with multiparae as the control.
Study Design: Retrospective cohort study.
Place and Duration of Study: University of Maiduguri Teaching Hospital over a period of one year (1st January 2007 to 31st December 2007).
Methodology: This retrospective cohort study reviewed the pregnancy outcome of nulliparae over one year, using multiparae as control. The data were analysed using SPSS. The χ2-test was used to compare the sociodemographic characteristics and pregnancy outcomes of the nulliparae and the multiparae. Multivariate logistic regression analysis was used to create a model for the factors that were independently associated with nullipara. A P-value of<0.05 was considered significant.
Results: Nulliparae contributed 259 (13.7%) of the 1,865 babies delivered during the period of study. The age ranged from 15 years to 42 years with mean age of 27.1 years ±5.3 years. Nulliparous women were more likely to be of younger age less than 20 years (P<0.001), educated (P=0.01) and booked early (P=0.001) when compared with multiparae. Also nulliparous women were more likely to have pregnancy induced hypertension (P=0.001) and episiotomy at delivery (P<0.001) but less likely to have anaemia (P=0.002) when compared with multiparae. Multivariate logistic regression showed that Nulliparae were more likely to be of younger age group (OR 7.22, P<0.001) and have malaria (OR 2.22, P=0.02), malpresentation (OR 5.68, P=0.02), abruptio placentae (OR 6.41, P=0.02), preterm delivery (OR 7.04, P=0.01), episiotomy (OR 7.74, P<0.001) and pregnancy induced hypertension (OR 3.53, P=0.01) but less likely to have anaemia at booking and fetal macrosomia.
Conclusion: Nulliparous women are at increased risk of certain adverse pregnancy outcome including malaria, preterm delivery and pregnancy induced hypertension. These adverse factors should be looked out for and excluded in order to improve maternal and fetal health in these women.