Page 89 - Contributed Paper Session (CPS) - Volume 5

CPS1108 Collins O. et al.

Evaluation and comparison of patterns of
maternal complications using generalised linear
models of count data time series
1, 2
Collins Odhiambo , Freda Kinoti 2
1 Institute of Mathematical Sciences, Strathmore University, Nairobi, Kenya
2 Department of Clinical Medicine and Therapeutics/CRISS Plus/School of Medicine, University
of Nairobi, Nairobi, Kenya

Abstract
Studying patterns of maternal complications is critical before, during and after
childbirth. However, there is limited information on comparative trends of
different maternal complications, particularly, in a resource-limited setting. In
this study we fit six different types of maternal complications namely ante-
partum haemorrhage (APH), eclampsia, obstructed labour, post-partum
haemorrhage (PPH), ruptured uterus and sepsis to time series generalized
linear model. We systematically compare the performance of the model in
light of real data by checking its flexibility and serial correlation and the
conditional distribution. We then, compute model fitting, assessment and
prediction analysis for each maternal complication. Additionally, we provide a
comparative review of the results by assessing the effect of basic emergency
obstetric and new-born care (BEmONC) and comprehensive emergency
obstetric and new-born care (CEmONC) services on trends in maternal
complications. Results show that women with APH, eclampsia and obstructed
labour at the time of delivery are significantly high. Complication rates did not
vary by maternal regions. Providers who perform obstetrical care should be
alert to the high rate of maternal medical complications associated with
obstructed labour. Introduction BEmONC and CEmONC package improved
performance of providers in reducing maternal and newborn complications
and mortality.

Keywords
Maternal complications; Count Data time series; Trends, Goodness-of-fit;
Conditional distribution

1. Introduction
Maternal complications namely ante-partum haemorrhage (APH),
eclampsia, obstructed labour, post-partum haemorrhage (PPH), ruptured
uterus and sepsis constitute to one of the leading causes of the burden of
disease for women of reproductive age throughout the world and contribute
to high levels of mortality and disability in developing regions 1. Maternal
conditions dominate the burden of reproductive ill-health, accounting for at
least 25% of the global burden of diseases, particularly in Kenya.

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