Determinants of Ectopic Pregnancy among Pregnant Women Attending Referral Hospitals in Southwestern parts of Oromia Regional State, Southwest Ethiopia: Case control study

Abstract

Background: Ectopic pregnancy (EP) is abnormal condition in which implantation of the blastocyst occurs outside the endometrium of the uterus. It is gynecological important, particularly in the developing world, because of the associated enormous rate of high morbidity, during the first trimester of pregnancy. A better understanding of its risk factors can help to prevent its prevalence. However, the determinants of ectopic pregnancy are not well understood and few researches conducted in our country were based on secondary data covering small scale area. Objectives: This study aimed to identify determinants of ectopic pregnancy among pregnant women attending referral hospitals in Southwestern part of Oromia regional state, Southwest Ethiopia. Methods: Multi-centered hospital based case control study was employed from June 1 to September 30, 2019. The study was conducted in five referral hospitals in Southwestern part of Oromia regional state, with sample size of 177(59 cases and 118 controls). After confirmed by ultrasound and hCG women with ectopic pregnancy were cases and women who had not diagnosed for ectopic pregnancy were controls. Data were entered by using Epi data version 3.1 and analyzed using SPSS version 23. Descriptive statistics were used to explore the data. All explanatory variables with p -value of <0.25 in bi-variable analysis then entered into multivariable logistic regression. Associated factors were identified at 95% confidence interval (p <0.05). Aggregate results were displayed using frequency tables. Results: From five referral hospitals 177(59 cases and 118 controls), one hundred seventy-four pregnant women (58 EP cases and 116 controls) were participated in the study. History of two or more induced abortions [AOR=3.95:95% CI: 1.22-13.05], at least one previous history of caesarean section [AOR=3.4:95% CI: 1.11-10.94], marital status (being single) [AOR=4.04:95%CI: 1.23-13.21], reporting Prior recurrent STD/STI [AOR=2.25:95%CI: 1.00-5.51], Women reporting prior history of emergency contraceptive pills use [AOR=3.04:95%CI:1.29-7.14] were more likely to have ectopic pregnancy with their respective AOR with 95%C. I Conclusion and Recommendation: It was found that having history of more than two induced abortions during previous pregnancy, marital status (single), recurrent STD/STI, experiencing at least one caesarean section for previous pregnancy and using emergency contraceptives pills use were found to be important determinants of ectopic pregnancy. Hospitals should give emphasis on prevention and early detection of risks of ectopic pregnancy and create awareness in order to reduce the burden of ectopic pregnancy.