Predictors of preterm birth in Western Ethiopia: A case control study

Abstract

Background Early neonatal death caused by preterm birth contributes the most for perinatal death. The prevalence of preterm birth continues to rise and is a significant public health problem. The exact cause of preterm birth is yet unanswered, as mostly preterm birth happens spontaneously. Predictors of preterm birth in developing countries like Ethiopia were not well investigated, and no study was conducted before this in the study area. Objectives To identify predictors of preterm birth in Western Ethiopia, 2017/2018. Methods Health facility-based unmatched case-control study was conducted from October 20/2017-march 20/2018 in 4 Hospitals. A total sample size of 358 women was recruited. From this 72 were cases and 286 were controls. Cases were mothers who gave Preterm birth, and controls were mothers who gave birth at term. Ethical clearance was obtained from Wollega University ethical review committee. A pre tested, structured questionnaire was used to collect data. Data entry and analysis was done using Epi Data 3.1 and SPSS version 21, respectively. Logistic regression was done to identify predictors of preterm birth. Result Three hundred fifty-eight women participated in this study of which 72 were cases and 286 were controls; making the overall response rate of 100%. Lack of antenatal care visit [AOR = 3.18, 95% CI 1.37–7.38]),(Having 1–2 antenatal care visit [AOR = 2.27, 95% CI 1.18–4.35]),history of previous preterm)[AOR = 5.19, 95% CI1.29–20.88],Short Interpregnancy Interval [AOR = 4.41.95% CI 2.05–9.47],Having Reproductive tract infections [AOR = 2.54, 95% CI 1.02–6.32] and having Obstetric complications [AOR = 2.48,95% CI 1.31–4.71] were found to be predictors of preterm birth. Conclusion and recommendation Risk factors of preterm delivery are multifactorial and depend on geographical and demographic features of the population studied. Hence results of studies from one area might not be applicable to another area. Antenatal care visits are unique opportunities for early diagnosis and treatment of problems. Therefore, antenatal care should be strengthened, and appropriate counseling should be given at each antenatal care follow up. Maintainning optimum birth interval through family planning, and early identification and treatment of reproductive tract infections are mandatory.

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

“…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 ].…”

“…Previous history of PTB was found in 14 studies [ 9 , 19 , 26 , 27 , 54 , 58 , 61 , 68 , 90 , 91 , 94 , 101 , 104 , 110 ] to be significantly associated with increased risk of PTB in subsequent pregnancies. One study in Tanzania [ 68 ] evaluating the impact of previous PTB on successive deliveries found an increasing risk of PTB with an increase in the number of previous PTBs.…”

“…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. Five of the included studies [ 36 , 57 , 58 , 71 , 74 , 76 , 90 ] also reported antepartum haemorrhage as a risk factor for PTB.…”

“…Anaemia in pregnancy was also reported to be associated with increased odds of PTB in eight of the included studies [ 18 , 19 , 49 , 56 , 63 , 76 , 77 , 108 ], with the risk of PTB increasing with its severity [ 56 ]. Other infections or conditions in pregnancy that were reported to increase the burden of PTB were bacterial vaginosis [ 105 ], tuberculosis [ 84 ], diabetes [ 108 ], depression [ 78 ], urinary and reproductive tract infections [ 39 , 71 , 90 , 104 ], opportunistic infections [ 47 ], and periodontal disease [ 26 , 51 , 100 ].…”

Preterm Delivery: Associated Risk Factors And Neonatal Outcomes in Duhok Hospital for Obstetrics And Gynecology

“…The number of antenatal care visits and previous obstetric history has also been linked to premature birth (Díaz-Rodríguez et al, 2021). Preterm delivery is more likely among women with prelabour rupture of fetal membranes (Abadiga et al, 2021) and recent pregnancy complications like preeclampsia or antepartum hemorrhage (Regasa et al, 2021).…”