Risk Factors of Hyperemesis Gravidarum among Pregnant Women in Bale Zone Hospitals, Southeast Ethiopia: Unmatched Case-Control Study

Background: Hyperemesis gravidarum is defined as severe nausea and repeated vomiting during pregnancy that prevents oral intake of food and leads to dehydration, ketonuria and weight loss. Even though the incidence of HG varies in different areas, approximately 0.5%-4.8% of pregnant women develops HG during their pregnancy. Early detection of HG risk factors could reduce maternal and fetal complications, healthcare and societal costs. Studies have investigated risk factors for HG outside Ethiopia, but the studies have reported conflicting results in terms of study design, lack of proper sample size and control group. Therefore, this study identified sociodemographic and clinical risk factors of HG among pregnant women in Bale zone hospitals, Southeast Ethiopia. Methods: Unmatched case-control study was conducted in Bale zone hospitals. A total of 396 pregnant women (132 cases and 264 controls) were successfully interviewed using structured and pre-tested questionnaires. Pregnant women with confirmed diagnosis of HG were considered as cases and women who attended antenatal service were assigned as controls. For each case, two controls were included in the study. Data were entered into Epi-data 3.1 and exported to SPSS version 21 for analysis. Frequency distribution for categorical variables, the mean and standard deviation for continuous variables were computed. Logistic regression analyses were done. A significant association was declared at a p-value less than 0.05. Results: Residing in urban areas (AOR=2.96; 95% CI=1.50-5.86), being in the first trimester (AOR=8.90; 95% CI=7.00-14.76) and the second trimester (AOR=9.08 95% CI=2.95-27.91), having perceived stress illness (AOR=7.31; 95% CI=2.22-24.09), have been employed in either government or private sector (AOR=0.20, 95% CI=0.02-0.52) were associated with HG. Conclusions: Maternal residence, occupation, and perceived stress illness were associated with HG during pregnancy. Healthcare providers should look for psychological stressors at first ANC visit and these stressors need to be minimized through reassurance and provision of extra psychological support during follow up of HG cases. Women also gave due attention for employment before they decided to be pregnant.