Prevalence and perinatal mortality associated with preterm births in a tertiary medical center in South East Nigeria

Abstract

BackgroundPreterm birth is a high risk condition associated with significant mortality and morbidity in the perinatal, neonatal, and childhood periods, and even in adulthood. Knowledge of the epidemiology of preterm births is necessary for planning appropriate maternal and fetal care.ObjectiveThe objective of this study was to determine the prevalence, pattern, and perinatal mortality associated with preterm births at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria.MethodsThis was a review of prospectively collected routine delivery data involving preterm deliveries that occurred between 1 January 2009 and 31 December 2013. Data analysis involved descriptive and inferential statistics at 95% level of confidence using SPSS version 17.0 for Windows.ResultsThere were 3,760 live births over the 5-year study period out of which 636 were preterm births, giving a prevalence rate of 16.9%. Spontaneous preterm births occurred in approximately 57% of preterm births while provider-initiated births occurred in 43%. The mean gestational age at preterm deliveries was 32.6±3.2 weeks while the mean birth weight was 2.0±0.8 kilograms. Approximately 89% of preterm births involved singleton pregnancies. Sixty-eight percent of preterm births were moderate to late preterm. The male:female ratio of preterm babies born during the period was 1.2:1. The adjusted perinatal mortality rate for preterm babies in the study center was 46.1% (236/512). The stillbirth rate for preterm babies was 22.0% (149/678) and the adjusted early neonatal death rate was 24.0% (87/363).ConclusionThe prevalence of preterm births and associated perinatal mortality were high which may be a reflection of suboptimal prenatal and newborn care. An urgent improvement in prenatal and newborn care is therefore needed in the study center in order to improve the capacity to prevent or abate preterm labor, and preterm premature rupture of membranes; and to reduce avoidable stillbirths. Further upgrading of personnel and facilities in the newborn special care unit is also required to minimize early neonatal deaths.

Characteristics and risk factors of preterm births in a tertiary center in Lagos, Nigeria

“…It reveals a prevalence rate of 16.8%, which falls outside the 9.5-15.8% prevalence reported by World Health Organization (WHO) for Sub-Saharan Africa [16] but is consistent with previous estimates between 15% and 23% from Nigeria [17–20]. Our single-center study design is similar to the aforementioned studies from Nigeria.…”

Prevalence of Preterm Birth and its Associated Factors among Mothers Delivered in Jimma University Specialized Teaching and Referral Hospital, Jimma Zone, Oromia Regional State, South West Ethiopia

“…The infection of the urinary system is the most prevalent bacterial infections occurred during pregnancy [12,15,16,21]. Similar to my results, has considered urinary system infection as a risk factor for premature birth [16].…”

“…Of these 80.5% (1729/2149) delivered at term (37-41 weeks), 16.3% (351/2149) delivered preterm (37 weeks), and 3.2% (69/2149) delivered post term (41 weeks gestation), preterm birth rate of 11.1% occurred in Sub-Saharan Africa and Jimma 51% of these babies were born below 37 completed weeks of gestation. The low rate of preterm birth found in present study might reflect success of different programs introduced by federal Ministry of Health to improve health service quality delivered to pregnant women including pre-pregnancy and pregnancy health care in the last decade [1,3,13,16,17,21,22]. …”

“…Majority of mothers are multi para 38% (27) having greater than or equal to three pregnancy and 32.3% (21) birth interval greater than 3 years followed by between 1-3 years 27.7% (20). Mothers who had hyper emesis gravid arum 20% (18) during pregnancy, 47.7% (21) had history of Abortion previously, 53.8% (21) had previous history of still birth, and 48.5% (32) had preterm labor, 16.6% (3) previous history of cesarean section, 41% (38) mothers were had pre mature rupture of membrane, 51% (26) had bleeding during pregnancy, 38% (17) had urinary tract infection (UTI) during pregnancy, 33% (2) chronic hypertension, 41% (27) were had preeclamsia during pregnancy state respectively, 43% (3) mothers were had diabetes mellitus (DM), 28% (12) were previous history of hospitalization during pregnancy and 24% (44) were had history of ANC follow up during pregnancy respectively of mothers who were give preterm birth. The results for statistical analysis were summarized in (Table 2).…”

“…Currently it is the only teaching and referral hospital in the south-western part of the country, providing services for approximately 15000 inpatients, 160000 outpatient attendants, 11000 emergency cases, and 4500 deliveries in a year coming to the hospital from the catchment population of about 15 million people. It is a teaching hospital with a total capacity of about 450 beds [17][18][19][20][21].…”