Published in PLOS One on 2026-08-28, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Shambal Kassahun Ferrede, Mulatu Werkina Eticha, Habtamu Molla Ayele, Kahsu Gebrekidan
Source: PLOS One • DOI 10.1371/journal.pone.0357043
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Obstetric interventions can improve maternal and neonatal outcomes when performed appropriately by skilled healthcare professionals. Appropriate use of forceps and vacuum extraction can reduce neonatal complications associated with operative vaginal deliveries. However, there is limited evidence on the prevalence of adverse neonatal outcomes and associated factors among operative vaginal deliveries in Northwest Ethiopia.
This study aimed to assess the prevalence of adverse neonatal outcomes and associated factors among births through operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital in Northwest Ethiopia.
A facility-based retrospective cross-sectional study was conducted among 303 mothers who underwent operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital from September 1, 2019, to August 30, 2021. Data was extracted using a structured questionnaire. The collected data was entered into Epi-Data version 3.1 statistical software and exported to IBM SPSS statistics version 24 for data analysis. Descriptive statistics were used to summarize the participants’ characteristics and neonatal outcomes. Bivariable logistic regression analysis was performed to identify candidate variables. Variables with a p-value < 0.25 were entered into the multivariable logistic regression model. Adjusted odds ratio (AOR) with 95% confidence intervals (CIs) were calculated to assess the strength of associations. Statistical significance was declared at a p-value of < 0.05 in the multivariable logistic regression analysis.
The prevalence of adverse neonatal outcomes among births delivered through operative vaginal delivery was 23.1% (95% CI: 18.68–28.21). The mean age and standard deviation of the study participants were 25.19 ± 4.7 years. All participants were married and 154 (50.8%) had obtained a college education or higher. The presence of grade ½ (AOR = 4.13, 95% CI: 1.96–8.69) and grade three meconium-stained amniotic fluid (AOR = 24.9, 95% CI: 6.14–46.06) and primigravidity (AOR = 2.49, 95% CI: (1.13–5.16) were significantly associated with adverse neonatal outcomes.
Adverse neonatal outcomes among births through operative vaginal delivery at the University of Gondar Comprehensive Specialized Hospital were high. Close intrapartum monitoring and early obstetric intervention among women with meconium-stained amniotic fluid and primigravid mothers are essential to reduce adverse neonatal outcomes associated with operative vaginal delivery.
Introduction
Operative vaginal delivery (OVD) refers to a vaginal birth assisted by forceps or vacuum devices during the second stage of labor to expedite delivery when maternal or fetal indications are present [1–4]. It is an important obstetric intervention that can improve maternal and neonatal outcomes when performed appropriately by skilled healthcare professionals. Globally, 10–20% of all deliveries may require some form of intervention and operative vaginal delivery accounts for 2–23% of all deliveries. In the United Kingdom, the OVD ranges from 10% to 15%. However, studies conducted in Ethiopia have reported rates ranging from 7% to 16.9% [5–8].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Shambal Kassahun Ferrede, Mulatu Werkina Eticha, Habtamu Molla Ayele, Kahsu Gebrekidan. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Neonatal survival and mortality predictors among low-birth-weight neonates: A Retrospective cohort study from Suhul Hospital, northern Ethiopia
