Association between past hormonal contraceptive use and preeclampsia among pregnant women in Gojjam zones, Amhara region, Ethiopia, 2017: case control study
Creators: name: Wolie, Abiyot
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2017

description: Background: Preeclampsia is a common problem of pregnancy often leading to significant maternal and fetal complications. In Ethiopia the major direct obstetric complications account for 85 percent of maternal deaths. Pregnancy induced hypertensive disorders are one of the common direct causes of maternal deaths in Ethiopia. Those women with a history of preeclampsia have a higher risk of developing preeclampsia in subsequent pregnancies but the effect of commonly used hormonal contraceptives on blood pressure is still not clear. There is no sound study conducted in Ethiopia concerning the specific risk factors, specifically contraceptive use and their effect on preeclampsia. Objective: To assess the association between past hormonal contraceptive use and preeclampsia among pregnant women who came for ANC or admitted in gynecology and obstetrics ward for delivery in the selected hospitals in Amhara Region, Ethiopia from August 2016 to October 2017. Methods: Institution based unmatched case control study design was conducted in Finote Selam, Bure, Debre Markos and Motta hospitals. These hospitals were selected due to their high patient flow among other hospitals in Gojjame Zones. Women who were diagnosed as having preeclampsia considered as cases and women without preeclampsia were controls. Cases and controls were selected consecutively in the ANC clinics, obstetrics and gynecology wards in the selected hospitals. The case to control ratio was 1:2. The total sample size was 330 (110 cases and 220 controls). The data was obtained through reviewing women"s record, taking some measurements and face to face interview using pretested questionnaire. The data was entered into EPI info and transferred into STATA version 14. Descriptive analysis like frequency, mean and standard deviation were calculated and finally the data was analyzed by logistic regression model using STATA version 14. Result: There was non-significant association between history of past hormonal contraceptive use and preeclampsia except implant. Independent risk factors of preeclampsia were family history of hypertension (COR= 3.04, 95% CI [1.13-8.23]), history of abortion (AOR= 3.17, 95 CI: [1.31-7.70]), change of paternity (AOR= 3.16, 95%CI: [1.47-6.83]) and multiple pregnancies (AOR= 2.68, 95%CI: [1.10-6.58]. On the other hand, using of implant (AOR=0.41, 95%CI: [0.18-0.93]) and fruit during this pregnancy (AOR = 0.36, 95% CI [0.18-0.72]) were found to be preventive factors for preeclampsia. Conclusion: History of past hormonal contraceptive use was non-significantly associated with preeclampsia except implants. History of abortion, change of paternity and multiple pregnancies were risk factors whereas fruit intake and implant use were preventive factors for preeclampsia. Recommendation: Researchers better to do further study on this maternal complication by using large sample size. Health workers better to give attention for pregnant women who have history of abortion and multiple pregnancies. It is better to encourage them to use implant as priority choice of contraception before their pregnancy.