Correlation Between Psychosocial Support and Maternal-Fetal Outcomes Among Women in Labour At A Low Resource Setting Health Facility in Uganda: Analytical Cross-Sectional Study
Abstract
Clement Munguiko, James Kateregga, Joseph Atukwatse, Josephine Namujju, Enos Mirembe Masereka, Clare Nankinga, Alice C. Alum, Samuel Okello, Safina Akello and Samuel Kabwigu
Introduction: Labour and delivery processes often evoke intense fear and anxiety among pregnant women. Although psychosocial support has been shown to reduce anxiety and fear during labour, the extent to which it is provided and its relationship with maternal and fetal outcomes remain poorly understood.
Purpose: To determine the level of psychosocial support and its association with maternal and fetal outcomes among pregnant women in labour.
Methods: This study was conducted at a regional referral hospital in Eastern Uganda using a quantitative analytic cross-sectional design. A total of 168 low-risk women in labour, with cervical dilatation of 5 cm or less, were enrolled. Perceived and observed psychosocial support were measured using a modified Multidimensional Scale of Perceived Social Support (MSPSS). Maternal complications and Apgar scores were assessed as maternal and fetal outcomes, respectively, and their association with perceived psychosocial support was analyzed using logistic regression. Sociodemographic and obstetric predictors of outcomes were also measured to account for confounding factors. Ethical approval was obtained from the Busitema University Faculty of Health Sciences Research Ethics Committee (No. BUFHS-2023-71).
Results: Almost all participants (97%) perceived the psychosocial support they received as adequate. However, direct observation revealed that only 14.3% actually received adequate support. Psychosocial support during labour was strongly associated with higher Apgar scores (aOR: 12.529, p = 0.011). No significant association was found between psychosocial support and maternal complications (aOR: 0.92, p = 0.946). Notably, the distance from home to hospital was significantly associated with fetal outcomes (Apgar score) (p = 0.048, 95% CI: 1.001–1.10). Additionally, parity, education level, and distance to the hospital were significantly associated with birth complications.
Conclusion: A clear disparity was observed between perceived and actual psychosocial support among women in labour. Women who perceived the psychosocial support they received as adequate were 12.5 times more likely to deliver babies with good Apgar scores compared to those who did not. These findings may inform policy, intrapartum care practices and further research needed to improve maternal and fetal outcomes especially in low resource settings.