ABSTRACT:
Introduction. Nosocomial infections represent a major public health problem, affecting over 1.4 million patients worldwide each year. In Africa, they are among the leading causes of maternal and neonatal mortality and postoperative morbidity. This study aimed to assess the effect of the duration of postpartum mother-newborn pair observation on the occurrence of nosocomial infections and the costs associated with normal delivery. Methodology. A prospective cohort study was conducted among mother-newborn pairs from three hospitals in Yaoundé, categorized according to practiced observation duration: ≥72h (Central Hospital), ≤48h (Gyneco-Obstetric and Pediatric Hospital), and ≤24h (Biyem-Assi District Hospital). The association between infections and observation duration was assessed using chi-square tests and logistic regressions. Direct and indirect costs were estimated and correlated with the length of hospital stay. Results. A total of 270 mother-newborn pairs were included. An overall rate of normal delivery was reported at 49.82%. The overall incidence of infection was 11.12% among delivering mothers and 18.14% among newborns. Our results showed a significant association between an observation duration of 48 hours or more and the onset of infection, with a RR of 5.0 (2.11 – 11.83) and a RR of 5.1 (2.53 – 10.38), respectively. Delivery costs (in FCFA) were (54,464.56 ± 15,778.94) for 24h, (81,750 ± 4,194.56) for 48h, and (93,150.79 ± 11,999.54) for 72h or more. The respective satisfaction rates were 90.73% (≤ 1 day), 74.07% (≤ 2 days), and 60.32% (≥3 days). Conclusion. A maternity stay of 48 hours or more significantly increases nosocomial infections and costs, while reducing patient satisfaction, suggesting the benefit of optimizing postnatal observation duration.