ObjectiveTo estimate the prevalence of obstructed labour, associated risk factors and outcomes across a network of referral hospitals in Nigeria.DesignRetrospective observational study.SettingA total of 54 referral‐level hospitals across the six geopolitical regions of Nigeria.PopulationPregnant women who were diagnosed with obstructed labour during childbirth and subsequently underwent an emergency caesarean section between 1 September 2019 and 31 August 2020.MethodsSecondary analysis of routine maternity care data sets. Random‐effects multivariable logistic regression was used to ascertain the factors associated with obstructed labour.Main outcome measuresRisk factors for obstructed labour and related postpartum complications, including intrapartum stillbirth, maternal death, uterine rupture, postpartum haemorrhage and sepsis.ResultsObstructed labour was diagnosed in 1186 (1.7%) women. Among these women, 31 (2.6%) cases resulted in maternal death and 199 (16.8%) cases resulted in postpartum complications. Women under 20 years of age (OR 2.03, 95% CI 1.50–2.75), who lacked formal education (OR 1.88, 95% CI 1.55–2.30), were unemployed (OR 1.94, 95% CI 1.57–2.41), were nulliparous (OR 2.11, 95% CI 1.83–2.43), did not receive antenatal care (OR 3.34, 95% CI 2.53–4.41) or received antenatal care in an informal healthcare setting (OR 8.18, 95% CI 4.41–15.14) were more likely to experience obstructed labour. Ineffective referral systems were identified as a major contributor to maternal death.ConclusionsModifiable factors contributing to the prevalence of obstructed labour and associated adverse outcomes in Nigeria can be addressed through targeted policies and clinical interventions.

中文翻译：

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尼日利亚 54 家转诊医院中难产的决定因素及相关结果

目的评估尼日利亚转诊医院网络中难产的发生率、相关危险因素和结果。设计回顾性观察研究。设置尼日利亚六个地缘政治区域共有 54 家转诊级医院。人口被诊断为难产的孕妇分娩期间，随后在2019年9月1日至2020年8月31日期间接受了紧急剖腹产手术。方法对常规产妇护理数据集进行二次分析。采用随机效应多变量logistic回归来确定与难产相关的因素。主要结局指标难产及相关产后并发症的危险因素，包括产时死产、孕产妇死亡、子宫破裂、产后出血和败血症。结果 1186年诊断为难产(1.7%) 女性。其中，31 例（2.6%）导致孕产妇死亡，199 例（16.8%）导致产后并发症。 20 岁以下女性（OR 2.03，95% CI 1.50–2.75）、缺乏正规教育（OR 1.88，95% CI 1.55–2.30）、失业（OR 1.94，95% CI 1.57–2.41）、未生育（OR 2.11，95% CI 1.83–2.43）、未接受产前护理（OR 3.34，95% CI 2.53–4.41）或在非正式医疗机构接受产前护理（OR 8.18，95% CI 4.41–15.14）的比例更高可能会经历难产。无效的转诊系统被认为是导致孕产妇死亡的一个主要原因。 结论 可以通过有针对性的政策和临床干预措施来解决导致尼日利亚难产和相关不良后果普遍存在的可改变因素。