Habetamu Tarikuwa, Abdeta Tilahun, Debella Adera, Eyeberu Addis, Yadeta Tesfaye Assebe
Hiwot Fana Specialized University Hospital, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia.
BMC Womens Health. 2025 Mar 15;25(1):122. doi: 10.1186/s12905-025-03649-8.
Globally, 75,000 maternal deaths occur each year from puerperal sepsis, with higher rates in low-income countries. In Ethiopia, puerperal sepsis is the fourth leading cause of maternal morbidity and mortality. This study aimed to identify determinants of puerperal sepsis among postpartum women admitted to public hospitals in Harar, eastern Ethiopia.
A retrospective unmatched case-control study was conducted from June 15 to July 15, 2022, among 423 postpartum women (106 cases and 317 controls) in Public Hospitals in Harar town, Harari Regional State, Eastern Ethiopia. Participants were selected using a simple random sampling method based on medical registration numbers. Data was extracted using a checklist and analyzed using SPSS version 25 statistical software. Logistic regression was used to identify determinants of puerperal sepsis, with adjusted odds ratios and a 95% confidence interval to estimate the strength and direction of the association. Statistical significance was declared at a p-value of less than 0.05.
The determinants of puerperal sepsis were found to be cesarean section delivery (AOR = 2.32, 95% CI 1.24-4.33), rupture of membranes lasting more than 24 h (AOR = 4.34, 95% CI 1.93-9.76), labor duration exceeding 24 h (AOR = 2.91, 95% CI 1.11-7.62), undergoing more than 4 vaginal examinations (AOR = 3.02, 95% CI 1.32-6.92), and being referred from other health institutions (AOR = 2.48, 95% CI 1.42-4.36).
This study identified factors that independently predict puerperal sepsis, including mode of delivery, duration of labor, duration of rupture of the membrane, number of vaginal examinations, and referral status. It is essential for all stakeholders to work together to reduce the risk factors of puerperal sepsis.
全球范围内，每年有75000例产妇死于产褥期败血症，低收入国家的发病率更高。在埃塞俄比亚，产褥期败血症是孕产妇发病和死亡的第四大主要原因。本研究旨在确定埃塞俄比亚东部哈勒尔市公立医院收治的产后妇女中产褥期败血症的决定因素。
2022年6月15日至7月15日，在埃塞俄比亚东部哈拉里地区州哈勒尔镇的公立医院对423名产后妇女（106例病例和317名对照）进行了一项回顾性非匹配病例对照研究。参与者根据医疗登记号码采用简单随机抽样方法选取。数据使用清单提取，并使用SPSS 25版统计软件进行分析。采用逻辑回归确定产褥期败血症的决定因素，用调整后的比值比和95%置信区间来估计关联的强度和方向。当p值小于0.05时宣布具有统计学意义。
发现产褥期败血症的决定因素包括剖宫产分娩（调整后的比值比=2.32，95%置信区间1.24-4.33）、胎膜破裂持续超过24小时（调整后的比值比=4.34，95%置信区间1.93-9.76）、产程超过24小时（调整后的比值比=2.91，95%置信区间1.11-7.62）、接受超过4次阴道检查（调整后的比值比=3.02，95%置信区间1.32-6.92）以及从其他医疗机构转诊（调整后的比值比=2.48，95%置信区间1.42-4.36）。
本研究确定了独立预测产褥期败血症的因素，包括分娩方式、产程、胎膜破裂时间、阴道检查次数和转诊状态。所有利益相关者共同努力降低产褥期败血症的风险因素至关重要。
