Determinants of Hyperemesis Gravidarum Among Pregnant Women in Public Hospitals of Mekelle City, North Ethiopia, 2019: Unmatched Case-Control Study

Abstract Background: Globally, hyperemesis gravidarum affects 0.3 to 3.6% of pregnant women. The etiology of hyperemesis gravidarum is unclear. In Ethiopia, limited studies have been conducted on the determinants of hyperemesis gravidarum. Therefore this study is aim to identify the determinants of hyperemesis gravidarum among pregnant women in public hospitals of Mekelle city, North Ethiopia. Methods: An unmatched case-control study was conducted from May to October 2019, with the ratio of 1:2(109 cases and 218 controls). Cases were women with hyperemesis gravidarum and controls were women who had no hyperemesis gravidarum. Cases were enrolled using consecutive sampling techniques and controls were selected by a systematic random sampling technique. Data were collected by interview using a structured questionnaire and analyzed using SPSS version 22. Statistical significance was considered at p- 0.05, and the strength of association was assessed by odds ratio and 95% confidence intervals. Result: Being housewife (AOR=2.43; 95% CI; 1.27, 4.62), unplanned pregnancy (AOR=2.58; 95% CI; 1.27, 5.24), had family history of hyperemesis gravidarum (AOR=3.85; 95% CI; 1.69, 8.75). H. pylori infection (AOR=3.50; 95% CI; 1.92, 6.39), high perceived stress (AOR=7.01; 95% CI; 2.56, 19.18) and being in the first and second trimester (AOR=6.01; 95% CI; 1.87, 19.26), and (AOR=4.73; 95% CI; 1.59, 14.00) were determinant of hyperemesis gravidarum. Conclusion and Recommendations: In this study; being a housewife, unplanned pregnancy, had a family history of hyperemesis gravidarum, H. pylori infection, high perceived stress, and being in the 1st and 2nd trimester of pregnancy were found to be the determinants of hyperemesis gravidarum. We recommend stress should be minimized through psychological support during follow up of pregnancy. Screening for H. Pylori should be taken as routine investigations for pregnant women who complain of nausea and vomiting.