Determinants of puerperal sepsis among mothers who give birth at Jigjiga Public Hospitals, Jigjiga, Somali Regional State, Eastern Ethiopia: a facility-based unmatched case-control study

Abstract

Puerperal sepsis is a significant public health concern in low-resource settings, including Ethiopia, where it is a major contributor to maternal mortality, accounting for 13% of maternal deaths. We investigated the determinants of puerperal sepsis among mothers who give birth at Jigjiga Public Hospitals, Somali Regional State, Eastern Ethiopia. A facility-based unmatched case-control design was employed, with a sample size of 226 (76 cases and 151 controls). The study was conducted at two public hospitals in Jigjiga, Eastern Ethiopia, from January 2022 to December 2022. Data was collected using a standardized structured questionnaire and medical record review. Data were analyzed using SPSS software version 26. Multivariate logistic regression analysis was used to identify the determinants of puerperal sepsis. The level of significance was set at 0.05. The mean age of the mothers was 30.2 ± 10.2 years for cases and 31.5 ± 6.7 years for controls. The results showed that Advanced maternal age (≥ 35 years) (AOR = 3.01; 95% CI: 1.02–8.83), fewer than three antenatal care (ANC) visits (AOR = 3.84; 95% CI: 1.75–8.43), undergoing five or more pelvic examinations during labor (AOR = 5.81; 95% CI: 1.68–20.13), and the presence of maternal anemia (AOR = 4.35; 95% CI: 2.33–8.13) were determinants of puerperal sepsis. This study found that advanced maternal age (≥ 35 years), attending fewer than three antenatal care (ANC) visits, undergoing five or more pelvic examinations during labor, and the presence of maternal anemia are significant determinants independently associated with an increased risk of puerperal sepsis. To reduce the risk of puerperal sepsis, efforts should focus on improving antenatal care coverage, minimizing unnecessary pelvic examinations, managing maternal anemia, and ensuring proper perineal care through adherence to clinical guidelines.