Determinants of puerperal sepsis among postpartum women admitted to hospitals in Dire Dawa, Ethiopia: an unmatched case-control study

Background: Puerperal sepsis is an infection of the genital tract that occurs at any time from 2 to 42 days of puerperium. Despite various efforts undertaken, it remains among the leading causes of maternal mortality, including in Ethiopia. However, studies in Ethiopia have been inconsistent and lacking in the study area. Therefore, this study was aimed at assessing puerperal sepsis's determinants, which could help in interventions. Methods: A hospital-based unmatched-case control study was used among 600 postpartum women (150 cases and 450 controls). Cases (postpartum women with puerperal sepsis) and controls (postpartum women without puerperal sepsis) were selected by a systematic sampling technique. Data were collected using a structured questionnaire and a medical record review, entered and cleaned by Epi DATA (version 3.1), and analyzed using SPSS (version 22). A p value of 0.25 at bivariate to select variables for multivariate and ≤ 0.05 at multivariate with 95% confidence intervals was considered statistically significant. Results: Determinants of puerperal sepsis were housewives, merchants, rural residences, home deliveries, cesarean deliveries, and vaginal examinations and prolonged rupture of membranes. Conclusion: Puerperal sepsis determinants are primarily obstetric-related, with occupation and residence being the most significant. Accordingly, early interventions on all these determinant factors of puerperal sepsis could make a difference in overcoming morbidity and mortality related to puerperal sepsis. Thus, hospitals are recommended to conduct further research and improve institutional delivery and use standard procedures during the labor and delivery.