Prevalence, Trends and Factors Associated with Abortion-Related Mortality in South-South Nigeria: A Five-Year Retrospective Study

Abstract

Background: Unsafe abortion remains a significant contributor to maternal mortality, particularly in low- and middle-income countries like Nigeria, where access to safe reproductive health services is often limited. Despite global efforts to reduce abortion-related deaths, the burden persists in many regions, including South-South Nigeria, where data on trends and determinants remain insufficient. Aims: To determine the prevalence, trends, and factors associated with abortion-related mortality over a five-year period in a tertiary facility in South-South Nigeria. Study Design: A retrospective descriptive study. Place and Duration of Study: Conducted in a tertiary health facility in South-South Nigeria, covering records from January 2019 to December 2023. Methodology: Data were collected using a validated data abstraction form from authenticated patient case files of women who presented with abortion-related complications. Sociodemographic and clinical characteristics of cases that resulted in mortality were analyzed. Descriptive statistics were used to summarize the data, while chi-square tests assessed associations between variables using SPSS version 28. Significance was set at P < 0.05. Results: A total of 311 abortion-related deaths were recorded over the five-year period. The overall abortion-related mortality rate was 28.8%, with the highest annual rate in 2021 (23.1%) and the lowest in 2023 (18.3%). The mean age of the deceased was 28.9 years (SD ±8.82). Sociodemographic factors significantly associated with mortality included age 25–34 years (P = 0.006), single marital status (P = 0.016), secondary level education (P =0.032), student occupation (P = 0.023), low socioeconomic status (P = 0.040), and urban residence (P = 0.037). Clinical factors associated with mortality included first-trimester abortions (P = 0.001) surgical methods (P = 0.001), hospital stay less than 24 hours (P = 0.002), and complications such as hemorrhage (P = 0.001). Conclusion: Abortion-related mortality remains a major public health challenge in South-South Nigeria, with identifiable sociodemographic and clinical factors contributing to poor outcomes. Efforts to reduce abortion-related deaths should focus on community education, timely clinical interventions, and equitable access to safe reproductive health services.