Research article Predictors of adverse pregnancy outcome at Hospitals in South Gondar Zone, North-central Ethiopia: A multicenter facility-based unmatched case-control study Dagne Addisu a, * , Shimeles Biru a , Maru Mekie a , Binyam Minuye b , Minale Bezie a , Wubet Alebachew b , Solomon Demis b , Enyew Dagnew a , Abenezer Melkie a a Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia b Department of Pediatrics, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia ARTICLE INFO Keywords: Adverse pregnancy outcome Predictors South Gondar Ethiopia ABSTRACT Background: Adverse pregnancy outcomes are the most significant public health problem which leads to serious short and long-term health consequences to the mother and the newborn baby. Adverse pregnancy outcomes, especially prematurity and low birth weights are the major cause of neonatal morbidity and mortality in Ethiopia, particularly in the study area. Therefore, this study was aimed to determine predictors of adverse pregnancy outcome among mothers who gave birth at Hospitals in South Gondar zone, North-central Ethiopia. Methods: Hospital-based unmatched case-control study was conducted. A total of 441 study participants with 147 cases and 294 controls were included. The study participants were selected by multi-stage sampling technique. A combination of chart review and interview were used. Data entry and analysis were done by using Epi data version 3.1 and SPSS version 23 respectively. Descriptive & analytical statistics were computed. In the binary logistic regression, both bivariable and multivariable analysis was computed. Statistical significance was considered at P < 0.05 and the strength of association were assessed by using the adjusted odds ratio with their 95%confidence interval. Result: A total of 147 cases and 294 controls were included. The mean age (SD) of study participants was 26.8  5.5 years. History of adverse birth outcome (AOR ¼ 6.39, 95%CI ¼ 2.55, 15.99), did not receive dietary coun- seling during pregnancy (AOR ¼ 5.17, 95%CI ¼ 2.09, 12.84), pregnancy induced hypertension (AOR ¼ 3.74, 95% CI ¼ 1.20, 11.62), history of hyperemesis gravidarum in the recent pregnancy (AOR ¼ 4.01, 95%CI ¼ 1.58, 10.21) and inter-pregnancy interval less than 24 months (AOR ¼ 2.02, 95%CI ¼ 1.04, 3.91) were significantly associated with adverse pregnancy outcome. Conclusion: This study showed that history of adverse pregnancy outcome, pregnancy induced hypertension, did not receive dietary counseling, history of hyperemesis gravidarum, and inter-pregnancy interval less than 24 months were significantly associated with adverse pregnancy outcome. This study implies the need to improve dietary counseling for pregnant mothers during antenatal care visits. Beside to this, counseling on birth spacing should be given to improve inter-pregnancy intervals. 1. Introduction Worldwide, women and children are among the most vulnerable group in terms of negative influences in the environment including inadequate nutrition, insufficient health care, and poor education. Pregnancy brings those factors as high risk for women and their fetus [1, 2]. Adverse pregnancy outcomes indicates those birth outcomes other than normal pregnancy outcome (normal live birth) which mainly include low birth weight(LBW), stillbirth and preterm birth [3, 4]. Adverse pregnancy outcomes are the most important vital statistics which is used to evaluate maternal and child health program and design-evidence based interventions. They are an indicator of the quality of Antenatal Care (ANC), medical services, and general health services to the mother and the children [5, 6, 7, 8, 9]. * Corresponding author. E-mail address: addisudagne7@gmail.com (D. Addisu). Contents lists available at ScienceDirect Heliyon journal homepage: www.cell.com/heliyon https://doi.org/10.1016/j.heliyon.2021.e06323 Received 17 December 2020; Received in revised form 27 January 2021; Accepted 16 February 2021 2405-8440/© 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by- nc-nd/4.0/). Heliyon 7 (2021) e06323