Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study

Abstract

Background Preterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia. Methods An institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05. Result The current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study. Conclusions The present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

A Scoping Review of Preterm Births in Sub-Saharan Africa: Burden, Risk Factors and Outcomes

“…Other reported sociodemographic factors included low socio-economic class [ 86 , 108 ], limited maternal education (only primary or no education) [ 77 , 95 , 104 , 106 ], rural residence [ 27 , 30 , 48 , 50 , 81 , 106 ], employment [ 41 , 86 ], Muslim mothers [ 41 ], mothers who had fear of delivery [ 41 ], and mother’s exposure to unfavourable working conditions including stressful jobs [ 41 ], exposure to vibration [ 12 ], and carrying heavy loads [ 24 ] which were all reported to increase the risk of PTB. Additionally, in 6 of the included studies [ 30 , 31 , 34 , 39 , 58 , 86 ], unmarried mothers had increased odds of having PTB compared to their married counterparts.…”

“…Lack of or underutilization of antenatal care (ANC) was by far the most reported obstetric risk factor associated with PTB. Twenty-six of the included studies [ 9 , 18 , 19 , 22 , 23 , 25 , 29 , 30 , 36 , 37 , 39 , 41 , 48 , 50 , 52 , 58 , 60 , 62 , 71 , 74 , 76 , 86 , 90 , 97 , 104 , 106 ] reported that pregnant mothers with fewer (<4 ANC visits) or with no ANC visits were more likely to have a PTB. In one study that compared the prevalence of PTB among mothers who had one, two, three or four ANC visits, the prevalence decreased with an increase in number of ANC visits (21.6%, 22.3%, 17.5% and 5.6%, respectively) [ 25 ].…”

“…Premature rupture of membrane (PROM) was another frequently reported risk factor of PTB reported in 15 of the included studies [ 9 , 18 , 19 , 20 , 23 , 27 , 29 , 37 , 50 , 74 , 76 , 77 , 86 , 91 , 103 ]. In addition, other adverse birth outcomes in previous deliveries such as previous abortions [ 49 , 63 , 77 , 81 , 104 ], caesarean delivery [ 26 , 86 ], stillbirths [ 19 , 49 ], miscarriages [ 26 , 94 ], low birth weight [ 26 , 68 ], complicated pregnancy/delivery [ 36 , 57 , 58 , 71 , 74 , 76 , 90 ], and perinatal death [ 68 ] were reported to be associated with increased odds of PTB.…”

“…Multiple gestation was another consistently reported risk factor for PTB that was reported in nine of the included studies [ 19 , 27 , 39 , 47 , 48 , 50 , 71 , 77 , 97 ]. All these studies reported an increased risk of PTB with multiple gestation.…”

Analysis of Maternal and Neonatal Outcome of Patients with Preterm Prelabor Rupture of Membranes

“…Consequently, expectant treatment is an important treatment for patients with PPROM. However, prolonged latency period increases the risk of ascending reproductive tract infection, which might lead to intrauterine infection [ 10 ]. Obstetrical strategies to treat patients with PPROM remain controversial, and the optimal delivery time is unclear [ 1 ], which depends on an evaluation of the risks and benefits of attempted pregnancy prolongation compared with expeditious delivery [ 11 ].…”