Determinants of primary postpartum hemorrhage among women who gave birth in Wachemo University Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia: a case-control study

BACKGROUND: Primary postpartum hemorrhage is a leading cause of maternal death worldwide, particularly in developing countries such as Ethiopia. A significant proportion of maternal deaths are attributed to postpartum hemorrhage. Despite its public health importance, there is a paucity of evidence regarding the determinants of primary postpartum hemorrhage in our country. OBJECTIVE: This study aimed to identify the determinants of primary postpartum hemorrhage among mothers who gave birth at Wachemo University Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Central Ethiopia. METHODS: A hospital-based unmatched case-control study was conducted from May to July 2023 by reviewing records from the previous two consecutive years (January 2021 to December 2022). A total of 348 maternal charts (87 cases and 261 controls) were selected using a simple random sampling technique, with the obstetric and gynecologic registration book serving as the sampling frame. Data were collected from medical records using a data abstraction form. Data entry was performed using EpiData version 4.6 and exported to SPSS version 26 for analysis. Binary and multivariable logistic regression analyses were conducted to identify determinants of primary postpartum hemorrhage. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) and a p-value ≤ 0.05 were used to determine statistical significance. RESULT: The findings of this study showed that obstructed labor (AOR = 5.2; 95% CI: 3.14-10.55), antenatal care follow-up (AOR = 1.42; 95% CI: 1.02-4.05), a history of antepartum hemorrhage (AOR = 3.45; 95% CI: 1.95-8.26), and maternal age > 35 (AOR = 3.51; 95% CI: 1.24-6.42) were significant determinants of primary postpartum hemorrhage. CONCLUSION: Maternal age, antenatal care follow-up during pregnancy, antepartum hemorrhage, and obstructed labor were identified as determinants of primary postpartum hemorrhage. Therefore, healthcare providers should closely monitor labor progression and take timely and appropriate interventions when necessary.