Determinants of Placental Abruption among Pregnant Women who attended Tikur Anbessa Specialized and Gandhi Memorial Hospitals: Institution Based Unmatched Case Control Study

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Addis Abeba University


Background: Placental abruption, also known as premature separation of placenta, is a significant cause of maternal morbidity and mortality, especially in low resource settings. Despite its negative maternal and fetal outcome, the determinant factors of placental abruption have not been sufficiently studied. Objective: This study aimed to identify risk factors associated with placental abruption among pregnant women who attended Tikur Anbessa Specialized and Gandhi Memorial Hospitals Addis Ababa, Ethiopia 2021. Methods: A Hospital-based retrospective unmatched case control study was employed at Tikur Anbessa Specialized and Gandhi Memorial Hospitals by reviewing medical chart of women admitted for 3 years from September 11, 2017 – September 10 2020. Among which 376 women (188 cases and 188 controls) were included in the study. After data was collected by using Kobo Collect version 1.27.3 it was exported and analyzed using SPSS version 25. To identify determinants of Placental abruption, Bivariable and Multivariable binary logistic regression analyses were done. Statistical significance was considered at a level of significance of 5%, and an adjusted odds ratio with 95% confidence interval was used. Result: Prevalence of PA was found to be 0.25% and six identified independent determinants of Placental abruption with AOR [95% CI] were identified. These were advanced maternal age (Age ≥35) [AOR=2.44; 95% CI: 1.13, 5.25], previous history of stillbirth [AOR=4.55; 95% CI: 1.11, 18.59], previous history of abortion [AOR=2.28; 95% CI: 1.22, 4.26], previous history of cesarean section [AOR=3.21; 95% CI: 1.64, 6.29], premature rupture of membranes [AOR=8.88; 95% CI: 3.27, 23.65] and preeclampsia [AOR=3.95; 95% CI: 1.54, 10.11]. Perinatal death among cases was 22 (11.3%) whereas there was only one maternal death recorded (0.5%). Conclusion and Recommendations: Prevalence of Placental abruption was low and advanced maternal age, premature rupture of membranes, and preeclampsia, as well as previous histories of stillbirth, abortion and cesarean section, were identified as independent determinants of placental abruption. Practitioners responsible for prenatal monitoring must pay attention to risk factors during prenatal care to prevent adverse maternal and fetal outcomes that may associate with placental abruption.



Placental abruption, Determinants, Case-control, Pregnant women