A Case-Control Study to Assess the Risk Factors of Ectopic Pregnancy in Two Referral Hospitals in Douala, Sub-Saharan Africa

Abstract

Background: Ectopic pregnancy (EP) remains a public health problem in Africa, with a prevalence of 1% - 4% of all pregnancies and a main contributor to the high maternal mortality rates. This study aimed to identify and quantify the risk factors associated with EP in two major referral hospitals in Douala, thereby informing strategies for improved prevention and management. Methods: A retrospective case-control study was conducted over five months, from February 1 to June 30, 2023, at the Douala General Hospital and the Gynaeco-Obstetric and Pediatric Hospital of Douala. Medical records of patients managed for EP between January 1, 2013, and December 31, 2022, were reviewed. Cases (EP) were compared with controls (intrauterine pregnancy, (IUP) in a 1:2 ratio, matched for age, parity, gravidity, and study site. Logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential confounders. Statistical significance was set at p Results: A total of 148 EP (cases) and 296 IUP (controls) were analyzed. Independent risk factors for EP included a history of prior EP (aOR = 38.45, 95% CI: 3.52 - 5.05, p Conclusion: This study confirms that established risk factors for EP, notably prior EP and its surgical treatment, are strongly associated with the condition in Douala. These findings emphasize the importance of targeted interventions, including detailed obstetric history assessment and tailored counseling, to mitigate EP risk in this population.