Mean difference in timing of first antenatal checks across regions and associated factors among pregnant women attending health facilities in Ethiopia: evidence from Ethiopian demographic health survey, 2019.

INTRODUCTION: Early initiation of antenatal care visits is an essential component of services to improve maternal health. Conducting a detailed study about the mean difference in timing at first antenatal checks across regions and factors associated with timing at first antenatal checks among women attending antenatal in Ethiopia is essential to ensure maternal and newborn health. Therefore, this study aimed to describe the mean difference in timing at first antenatal visits and associated factors among pregnant women attending different health facilities across regions in Ethiopia. METHOD: The Ethiopian Demographic and Health Survey (EDHS) conducted a community-based cross-sectional study in 2019. In this study, data about the timing of the first antenatal check-ups were requested from the Demographic Health Survey in February 2023, and the required variables were downloaded in SAS and SPSS formats from the data set. A total of 2935 women from nine regional states and two city administrations with an age range of 15 to 49 years were included in the study. The mean difference in timing at first antenatal check-ups, its correlation and various factors were estimated using multiple linear regressions to identify factors. RESULT: The majority of the 2034 (69.3%) of pregnant women who participated in the study were rural residents. The mean (± SD) age of the pregnant women was 29 (± 6.5) years. Approximately 32.5% of pregnant women visited their first antenatal check after 4 months of pregnancy. The results showed that counselling by health workers during a previous pregnancy (p < 0.01) significantly predicts timing at first antenatal checks in months holding previous delivery, previous antenatal care at both government and private facilities, ever attended school, and highest educational level. Timing at the first antenatal check-in months is expected to decrease by 0.99 months for every counselling session at each pregnancy. The results of the analysis suggested that the regression model significantly predicted timing at the first antenatal check (p = 0.001). CONCLUSION: The mean difference in timing at the first antenatal check in months among Ethiopian pregnant women relatively significantly varies in two regions. Previous pregnancy counselling by health workers positively influences the timing of first antenatal check-ups for subsequent antenatal check follow-ups in Ethiopia.

Determinants of ectopic pregnancy among pregnant women attending referral hospitals in southwestern part of Oromia regional state, Southwest Ethiopia: a multi-center case control study.

BACKGROUND: Ectopic pregnancy is an 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 associated with 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. 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: 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. Final sample size includes 59 cases and 118 controls. Data were entered by using Epidata 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). RESULTS: Out of 177 (59 cases and 118 controls) participants, 174 (58 cases and 116 controls) were participating in the study. Prior two or more induced abortions [AOR = 3.95:95% CI: 1.22-13.05], 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 sexual transmitted infection [AOR = 2.25:95%CI: 1.00-5.51], prior history of tubal surgery [AOR = 3.32:95%CI: 1.09-10.13], were more likely to have an ectopic pregnancy with their respective AOR with 95%CI. CONCLUSION: It was found that having a history of more than two induced abortions during previous pregnancies, marital status (single), recurrent sexual transmitted infection, prior history of tubal surgery and experiencing prior caesarean section were found to be 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.

Neural tube defects among new borns: a cross-sectional study.

Background: Neural tube defects are a major public health issue that contributes significantly to morbidity and mortality, particularly in low-income countries such as Ethiopia. In Ethiopia, particularly in the study setting, there is a paucity of data on the prevalence, magnitude, and associated factors of neural tube defects. As a result, the purpose of this study was to evaluate neural tube defects and associated factors in JUMC. Methods: This study was an institution-based cross-sectional study conducted from June to September 2021. Data was collected using a structured questionnaire adapted from previous literature. Data were analyzed using SPSS version 26 software. Logistic regression analysis was performed to assess the association between dependent and independent variables. Independent variables with a p-value < 0.05 were taken as statistically significant with neural tube defects. Results: The prevalence of NTDs in this study was 3.6%. Preterm newborns with GA < 34 AOR 2.9(1.2-9.7), newborns with birth weight b/n 1,000-1,499 AOR 5.2(1.1-9.4), born with weight b/n 1,500-2,499 AOR 2.1(1.3-8.7), exposure to smoke AOR 2.1(1.2-8.8), radiation AOR 6.8(1.3-14.5), at least one history of abortion AOR 10.1(7.2-21.0) and mothers with AED intake AOR 5.7(2.3-18.4) were found to be associated significantly. Conclusion: The results indicated a significant frequency of neural tube abnormalities in newborns. The use of AEDs, abortion, and radiation have all been linked to those NTD cases. Pregnant women are advised to learn more about the need of beginning prenatal care as soon as possible because the aforementioned issues will be addressed during this treatment.

Determinants of prelabor rupture of membrane among pregnant women attending governmental hospitals in Jimma zone, Oromia region, Ethiopia: A multi-center case-control study.

BACKGROUND: Prelabor rupture of membrane defined as the rupture of fetal membranes before the beginning of uterine contractions, is a common complication of pregnancy and the leading cause of preterm birth. In Ethiopia, the prevalence of prelabor rupture of membrane varied significantly between settings due to variations in risk factors. Besides, there was no study conducted using primary data, particularly in the Jimma zone, Ethiopia. Therefore, this study aimed to identify determinants of prelabor rupture of membrane among pregnant women attending governmental hospitals in the Jimma zone, Oromia region, Ethiopia. METHODS: An institutional-based unmatched case-control study design was conducted from October 15 to December 15, 2021, at four governmental hospitals. A consecutive sampling technique was used to select 316 participants (79 cases and 237 controls). Women with prelabor rupture of the membrane were confirmed by history, sterile vaginal examination, and ultrasound as cases, and their counterparts as controls. An interviewer-administered questionnaire was used to collect data on maternal (obstetric, medical, behavioral) and fetal-related characteristics. The data were entered into Epi Data version 4.6 and analyzed using SPSS version 25. Descriptive statistics, bi-variable, and multivariable logistic regression were computed. The odds ratio with a 95% confidence level was used, and the significance level was declared at a p-value < 0.05. RESULTS: A total of 316 participants (79 cases and 237 controls) were included in this study. Pregnancy-induced hypertension (AOR = 3.06, 95% CI: 1.41-6.64), history of abortion (AOR = 3.67, 95% CI: 1.56-8.65), urinary tract infections (AOR = 2.61, 95% CI: 1.13-6.06), abnormal vaginal discharge (AOR = 2.65, 95% CI: 1.21-5.79), maternal khat chewing (AOR = 3.40, 95% CI: 1.70-6.80), mid-upper arm circumference less than 23 cm (AOR = 2.80, 95% CI: 1.51-5.19), and fetal presentation (breech) (AOR = 2.63, 95% CI: 1.10-6.28) were determinants of prelabor rupture of membrane among pregnant women. CONCLUSION: This study revealed that the aforementioned factors were found to be determinants of prelabor rupture of membrane among pregnant women. Therefore, hospitals should give focus to the early screening, diagnosis, and treatment of pregnancy-induced hypertension, urinary tract infection, and abnormal vaginal discharge to reduce the burden of prelabor rupture of membranes.