Prevalence and factors associated with failed induction of labor in Kawempe National Referral Hospital

Abstract

Background: Induction of labor is the artificial stimulation of uterine contractions before the spontaneous onset of labor to achieve vaginal delivery. Failed induction of labor is associated with poor maternal and neonatal outcomes compared to spontaneous labor. There is limited work done on predictors of failed induction of labor in Uganda and none in the study area. This study was aimed at determining the prevalence and factors associated with failed induction of labor in Kawempe National Referral Hospital. Method: Institution- based cross-sectional study was conducted among 279 women who were eligible for induction using simple random sampling. The data were collected from 15th March to 30th May 2024 using a structured questionnaire and extraction from maternal files in the electronic medical record. Then data was entered into the excel and analyzed using Statistical Package for the Social Sciences version 24. Descriptive statistics were performed to describe the study population. A chi-square test was adopted for a bivariate analysis with 95% confidence level. Level of significance at < or equal 0.20. In a multivariate analysis a binary logistic regression was adopted with 98% confidence level and level of significance at < or equal 0.20. Results: A total of 279 women were recruited to the study. Of these 142 (51%) were aged 25 to 34 years and 198 (71%) were urban residents. The induction protocol was followed in 259 (93%) of the participants. Ninety-six of the women had a failed induction of labor representing a prevalence of 34%. Women in whom induction protocols were not followed were 9 times more likely to have a failed induction. [AOR 9.2 (95% CI: 2.8-30.2)]. Women of maternal age less than 24 years were 50% less likely to have a failed induction of labor than women older than 34 years [AOR 0.5 (95% CI: 0.3-0.9)].Conclusion: The study revealed that the prevalence of failed induction of labor was 34%. Not following induction protocol was significantly associated with failed induction of labor. Maternal age less than 24 years reduced the rate of failed induction of labor. Following the induction protocol was recommended.