Prevalence and Risk Factors of Preterm Birth Among Pregnant Women Admitted at the Labor Ward of the Komfo Anokye Teaching Hospital, Ghana

Abstract

Preterm birth is a global epidemic and a leading cause of neonatal mortality in Sub-Saharan Africa. We evaluated the prevalence and risk factors of preterm birth among women attending the labor ward for delivery at a tertiary hospital in Ghana. This comparative cross-sectional study was conducted among a cohort of 209 pregnant women admitted to the labor ward of the Komfo Anokye Teaching Hospital (KATH). Pregnant women who delivered between 28 and 36 completed weeks of gestation were classified as preterm delivery whereas those who delivered after 37–42 completed weeks were described as term. Sociodemographic, clinical, and obstetric data were collected from patient's folder and hospital archives. Categorical variables were analyzed and expressed as frequencies and proportions. We determined the association between obstetric factors and preterm delivery with multiple logistic regressions. Significance level of the strength of association was determined at p-value < 0.05. of the 209 participants, the prevalence of preterm birth was 37.3% (78/209) whereas 62.7% (131/209) delivered at Term. Intrauterine growth restriction (IUGR) [aOR = 2.15, 95% CI = (1.819.55), p = 0.0390], HELLP (hemolysis, elevated liver enzymes and low platelet count) syndrome [aOR = 3.94, 95% CI = (1.64–9.48), p = 0.0020], early gestational obesity [aOR = 2.11, 95% CI = (1.31–11.92), p = 0.0480] and preeclampsia [aOR = 4.56, 95% CI = (1.63–12.76), p = 0.004] were identified as independent risk factors of preterm birth. Prevalence of preterm birth was high among women attending labor admission at the Komfo Anokye Teaching Hospital and this was independently influenced by IUGR, HELLP syndrome, early gestational obesity, and preeclampsia. Identifying early signs of adverse pregnancy outcomes would inform the need for management policy to prevent high prevalence of preterm births.

Prevalence and associated risk factors of preterm and post-term births in Northern Ghana: a retrospective study in Savelugu Municipality

“…Teenage mothers (thus, mothers aged less than 20 years) were 13 times more likely to deliver prematurely. An analogous pattern was found among Brazilian (16) and Nigerian (11) mothers who were less than 20 years old with an increased risk of preterm births but incongruent with some retrospective studies in Southern Ghana (7,17) , Kenya (10) , and Ethiopia (12) . Teenagers (young mothers) are still in the active phase of physiological, psychological, emotional, biological, and physical maturity and development.…”

“…By applying margin of error (e) of 5%, and standard normal variate (z) at 95% confidence level of 1.96, the sample size was initially estimated at 339. The final sample size was rounded off to 356 after adding 5.0% non-response rate (7) . Afterward, probability proportional to size technique was used to estimate the sample sizes for the five major public health facilities in the study area (Table 1).…”

Proportion and factors influencing client satisfaction with delivery services in health facilities in the Sissala East Municipality, Ghana: A cross‐sectional study

“…4 Previous studies showed that preterm birth and stillbirths are associated with maternal problems, such as hypertensive disorders of pregnancy, nonobstetric complications, obstetric hemorrhage, and pregnancy-related infections. 5,6 Reduction in maternal mortality can be achieved by making health services available, accessible, and of quality to women in cases of complications related to pregnancy and childbirth. [7][8][9] The most common evidence-based practice for improving quality care includes active referral and actionable information systems, adequate flow of communication, respect, dignity preservation, supporting women emotionally, engagement of talented and motivated human resources, and making available essential physical infrastructure or resources.…”

“…Previous studies showed that preterm birth and stillbirths are associated with maternal problems, such as hypertensive disorders of pregnancy, nonobstetric complications, obstetric hemorrhage, and pregnancy‐related infections 5,6 . Reduction in maternal mortality can be achieved by making health services available, accessible, and of quality to women in cases of complications related to pregnancy and childbirth 7–9 .…”

Prevalence and Predictors of Gestational Diabetes Mellitus in Sub‐Saharan Africa: A 10‐Year Systematic Review

“…membrane rupture, caesarean section, polyhydramnios and fetal macrosomia [3][4][5][6]. GDM prevalence is estimated to be about 15% globally [7] and varies between 2% and 6% in most racial/ethnic groups studied, 10%-20% among high-risk populations [8].…”