Risk factors for hyperemesis gravidarum among pregnant women attending antenatal clinic at Kawempe Hospital : A case-control study

Abstract

Introduction: Hyperemesis gravidarum is the most severe form of nausea and vomiting during pregnancy. The occurrence of HG varies in different areas, affecting approximately 0.5%-4.8% of pregnant women. HG is the commonest indication for admission to hospital in the first trimester of pregnancy. Not enough emphasis is placed on the risk factors for HG despite their higher association with maternal and fetal morbidity and mortality risk. In Uganda, no studies have been carried out to determine the risk factors for HG. Identifying the risk factors for HG could help reduce maternal and fetal complications by providing close follow up for those at risk. Objective: To determine the risk factors for Hyperemesis gravidarum among pregnant women attending antenatal clinic at Kawempe Hospital. Methods: Unmatched case-control study was conducted at Kawempe Hospital. A total of 135 pregnant women attending antenatal clinic (45 cases and 90 controls) were recruited. For each case, two controls were included in the study. Cases were defined as pregnant women of any gestational age and parity with history of vomiting of more than 5 times per day in this pregnancy and not treatment for malaria or urinary tract infection whereas controls were defined as pregnant women of any gestational age and parity without history of vomiting of more than 5 times per day. Data were entered into Kobo Collect online version and exported to Stata version 14.1 for bivariate analysis. Multivariate logistic regression analysis was done to assess the risk factors independently associated with HG. A significant association was declared at a p-value less than 0.05. Results: Among various factors studied, having a previous history of abortion (AOR= 4.23; 95% CI=1.42-12.54) and family history of HG (AOR= 4.88; 95% CI=1.81-13.16) were the only factors found to be associated with HG. Conclusion: Having a previous history of abortion and family history of HG were associated with HG during pregnancy. Recommendations: These factors are not easily modifiable, but identification of these factors may be useful in determining those women at risk for developing HG and providing active screening for those at risk and frequent reviews especially in the first trimester. HG should be managed as they present as no modifiable factors were found.