Factors Associated with Neural Tube Defects among Women Who Gave Birth at Adama Hospital Medical College, Adama, Ethiopia: A Case Control Study.

Background: Neural tube defects (NTDs) occur as a result of incomplete closure of the neural tube by the embryonic age of 26 to 28 days. Addressing factors associated with NTDs would help to identify and prioritize high-risk women, which in turn guides the preventive strategy. The study aimed to identify factors associated with NTDs among women who gave birth or had a second-trimester abortion at Adama Hospital Medical College, from January 1st to December 31st, 2019. Methods: Hospital based unmatched case-control study was conducted on 344 women. Data were analyzed with SPSS 20. Descriptive statistics were computed. Binary logistic regression analysis was performed to determine factors associations with NTDs. Results: The odds of having a fetus with NTDs were 2.19 times higher among women who are not in a marital relationship (AOR = 2.19; 95% CI: 1.13, 4.25). Women with a previous history of Abortion or stillbirth had 3 fold increased risk of having a fetus with NTDs (AOR = 3.05; 95% CI: 1.58, 5.88). Inadequate housing condition nearly doubles the odds of having a fetus with NTDs (AOR = 1.91; 95% CI: 1.20, 3.04). Folic acid or multivitamin supplementation early in pregnancy reduced the odds of having a fetus with NTDs by 43% (AOR = 0.57; 95% CI: 0.35, 0.91). Conclusion: Being not in a marital relationship, previous history of abortion or stillbirth, and living in inadequate housing conditions were risk factors for NTDs, while multivitamins or folic acid supplementation was a protective factor.

Determinants of uterine rupture among cases of Adama city public and private hospitals, Oromia, Ethiopia: a case control study.

BACKGROUND: Ethiopia is among the ten world countries with highest maternal death rates that accounts for more than 59% of global maternal deaths. Uterine rupture is one of the dangerous obstetric problems with high potential of causing maternal and neonatal morbidity and mortality. The case fatality rate of uterine rupture is high and hence identifying factors associated with uterine rupture remains important to guide decision makers and practitioners. The study aimed to identify factors associated with uterine rupture among clients managed in Adama city public and private hospitals during January 2011 to December, 2015. METHODS: Unmatched case control study design was employed. The sample size was determined using computer software considering the basic statistical assumptions and accordingly a total of 432 women, (144 with uterine rupture as cases and 288 with spontaneous vaginal delivery as controls) managed in all hospitals during the study period were included in the study. A data collection tool that contains available variables was designed and used to extract data from log books and client cards. Data were entered into EPI-Info-7 and exported to Stata-12 for cleaning and analysis. The study participants were characterized using descriptive statistics. The associations between uterine rupture and independent variables were modeled using binary logistic regression analysis. The association between independent variables and uterine rupture was estimated using odds ratio with 95% confidence intervals. The statistical significance of the association was declared at P-value < 0.05. RESULTS: The odds of having a uterine rupture were found to be more than six times higher among rural residents (AOR = 6.29; 95% CI: 3.39, 11.66) compared to urban. Other independent predictors include gravidity of five or more (AOR = 27.89; 95% CI: 8.42, 92.34), having a history of cesarean section scar (AOR = 9.94; 95% CI: 3.39, 11.66) and not having an antenatal care visit (AOR = 9.64; 95% CI: 4.37, 21.29). CONCLUSION: Rural residence, multigravidas, cesarean section scar and not having an antenatal care visit were independent predictors of uterine rupture in the current study. Therefore, improving access and strengthening essential obstetric care, antenatal and family planning services with complete packages are crucial interventions in the reduction of the odds of having uterine rupture. In addition, the strengthening of the referral system is mandatory for women residing in rural areas.