Determinants of Preterm Birth at the Postnatal Ward of Kenyatta National Hospital, Nairobi, Kenya

Abstract

Background: Preterm birth, delivery prior to 37 completed weeks or 259 days gestation, is a worldwide maternal and perinatal challenge and is a leading cause of neonatal morbidity and mortality. Preterm birth remains the leading cause of perinatal and postnatal mortality and morbidity especially in developing countries where the health care services are suffering from limited resources. Premature babies usually suffer from both immediate and long term consequences. Right after birth, they have difficulties in breathing, temperature regulation, bleeding, infection and other problems due to organ immaturity. Their growth and developmental milestones will also be affected leading poor physical, mental, educational and psychosocial problems as a long term consequences. Preterm deliveries were responsible for 1 million out of the 6.3 million deaths of children under 5 in 2013 [1]. In Kenyatta National hospital, few studies have been carried out to determine the prevalence and factors associated with preterm birth. Hence the aim of this study is to determine the prevalence and factors associated with preterm birth at Kenyatta national hospital (KNH), Nairobi, Kenya. Materials and Methods: This was a hospital based descriptive cross-sectional study involving randomly selected respondents (N = 183) from post natal ward of Kenyatta National Hospital. Systematic random sampling method was applied to recruit the study respondents. A pre-tested semi-structured questionnaire was employed to collect information on the possible determinants of Preterm birth. Data was analysed using SPSS software version 22.0. Descriptive analysis was done using mean and frequency proportion. Inferential analysis using chi-square test was used to establish association different variables. The ethical approval to conduct the study was obtained from KNH-University of Nairobi Ethical Review Committee (KNH-UoN ERC). Permission to collect data was sought from the KNH and consent was obtained from the selected respondents before admin- The determinants of preterm birth are multifactorial including history of abortion, preterm birth, urinary tract infection, hypertension and alcohol consumption during pregnancy. Most of these risk factors of preterm birth are controllable if reproductive age mothers are educated properly. It is very important for antenatal mothers to adhere to the guidelines of antenatal visits so that those at risk are spotted and close monitoring can done in order to reduce this high rate of preterm birth and its negative consequences. Strategies to avert the high prevalence of preterm birth and its associated morbidity and mortality must be given priority at national, regional and international levels, so that the Millennium Development Goal (MDG) 4 can be achieved.

Epidemiology of preterm birth in Ethiopia: systematic review and meta-analysis

“…Those women who experienced PIH were more likely to have PTB. This result is in agreement with result of studies conducted in Ethiopia and other countries [ 58 , 62 , 63 ]. This might be due to reduction of the utero-placental blood floor by hypertension leading to intrauterine growth restriction finally causing preterm birth.…”

Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis

“…Presence of malaria was associated with PTB as evidenced by the pooled analysis of four studies (AOR 3.08; 95% CI: 2.32-4.10) [42,44,79,83]. The pooled analysis of two studies identified that UTI was significantly associated with PTB (AOR 5.27; 95% CI: 2.98-9.31) [37,64] (Fig. 5).…”

“…The presence of chorio-amnionitis (AOR 3.8; 95% CI: 1.3-10.8) [72] and placenta praevia was correlated with PTB (ARR 3.30, 95% CI: 1.34, 8.14) [79]. The pooled analysis of four studies displayed that history of still birth/abortion was positively associated with PTB (AOR 3.93; 95% CI: 2.70-5.70) [10,37,57,64]. The pooled effects of four studies displayed that history of PTB increased the odds of PTB (AOR 3.45; 95% CI: 2.72-4.38) [10,46,64,69] (Fig.…”

“…, 11 from Ethiopia[52][53][54][55][56][57][58][59][60][61][62][63], 6 from Kenya[5,54,[64][65][66][67], 7 from Malawi [4, 6, 68-72], 3 from Sudan [10, 73, 74], 3 from Zambia [75-77],3 from Zimbabwe [78-80], 2 from Uganda [7, 81], 2 from Mozambique[82,83], 1 from Rwanda[84], and 1 from Madagascar[85]. Twenty five studies were done by cohort study design[33, 35, 36, 39, 41, 43, 45-50, 59, 61, 65-68, 70, 75, 77, 80, 83-85], 9 studies by case control study design[7,10,37,38,53,55,57,73,79] and 24 studies by cross sectional study design[4-6, 34, 40, 42, 44, 51, 52, 54, 56, 58, 60, 62, 64, 69, 71, 72, 74, 76, 78, 81, 82] (Table 1).…”

Short birth interval predicts the risk of preterm birth among pregnant women in Sub-Saharan Africa: A systematic review and meta-analysis

“…A total of 10 studies that assessed the association of short birth interval with preterm birth in Sub-Saharan African countries were included in this review. Five of the included studies were conducted in Ethiopia (18)(19)(20)(21)(22), two in Tanzania (23,24), two in Kenya (25,26), and one in Ghana (27). Of the ten studies two were cohort study (20,24), ve case-control (18,(21)(22)(23)27) and three cross-sectional (19,25,26).…”