Risk Factors for Preterm Labor among Women Attending El Shatby Maternity University Hospital, Alexandria, Egypt

Abstract

Introduction: Despite the progress made in perinatal medicine over the past two decades, the problem of preterm labor continues to frustrate satisfactory reproductive outcomes and its prevention still awaits needed improvements. Several factors have been identified to be associated with preterm birth (PTB). Objective:To identify the possible epidemiological risk factors contributing to the occurrence of preterm birth among women attending El Shatby Maternity University Hospital.Methods: A case control study was carried out. Two hundred women who delivered preterm babies (from 22 weeks to less than 37 completed weeks of gestation) were matched for BMI with 200 women who delivered full term babies (equal to or more than 37 completed weeks of gestation). Data were collected using a face to face interview, along with a record review. The variables found to be significantly related to preterm birth by the initial univariate analysis were further analyzed using a multiple logistic regression analysis.Results: Being primigravida, with hypertensive disorders of pregnancy, antepartum hemorrhage, and previous history of preterm birth were found to be associated with a high probability of PTB (OR > 10.5). Past history of gynecological operations and history of urinary tract infection were found to be associated with a moderate probability of PTB (OR>4.5-10.5).Conclusion: Improvement of the current practice of screening for and the treatment of either gynecological or chronic medical disorders that could complicate pregnancies could decrease the risk of preterm birth.Approximately 30-35% of PTB are induced or iatrogenic because of medical or obstetric complications; 40-45% are spontaneous, and 25-30% are due to preterm (pre-labor) rupture of membranes (PPROM) [7]. Despite the progress made in perinatal medicine over the past two decades, the problem of preterm labor continues to frustrate satisfactory reproductive outcome and its prevention still awaits needed improvements [8]. Several factors have been identified to be associated with PTB. However, such an association does not establish causality. The American College of Obstetricians and Gynecologists guidelines Stated that the clinical predisposing factors of PTB were prior PTB, smoking, vaginal bleeding during pregnancy, and short cervix [9]. Additionally, many studies have shown other risk factors for PTL such as extremes of maternal age such as young or old maternal age, short inter-pregnancy intervals, low maternal bodymass index (BMI), twin pregnancy, pre-existing chronic diseases such as, hypertensive disorders of pregnancy, diabetes and infections [10]. From these findings, the question has emerged regarding what are the risk factors for PTL in Egypt. ObjectiveThe current study was conducted in order to identify possible epidemiological risk factors contributing to the occurrence of preterm

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

“…Nulliparous were more likely to have a premature birth than multiparous women. This finding is in agreement with a study conducted in Egypt, which reported the strong association between nulliparity and PTD might be explained by the presence of additional variables like preeclampsia and accidental bleeding (El Beltagy et al, 2016). Mayo et al found an increased risk for spontaneous preterm labor among nulliparous teenagers (Mayo et al, 2017).…”

Determinants of Tocolysis Failure in Preterm Labor: A Case-Control Study in Two Hospital in Yaounde

“…We found that the persistence of the temperature ≥ 38°C after 48 hours of tocolysis exposed as twice as high the risk of tocolysis failure corroborating the study by Chansamouth et al who had similar results [23]. These results are super impossible with many series in Africa where malaria was the leading cause of fever during pregnancy [10]. Failure of tocolysis in patients with persistent fever for more than 48 hours is reported to be due to lack of etiological diagnosis or failure of etiological treatment.…”

“…The common hypothesis which state that the increased risk of preterm birth among aged mothers is largely explained by early labor induction for medical conditions as sustained by Khalil et al [9] was not confirmed in their study and they showed that advanced maternal age was independently associated with spontaneous prematurity, as McIntyre et al concluded in a population based cohort study [8]. This age was significantly associated with the failure of tocolysis in our study, because most of these patients were primiparous; primiparity being associated with poor antenatal care (ANC) [10] and high susceptibility to malaria [11] as we are in an endemic zone, and therefore to preterm labor. Malaria being one of the leading cause of preterm labor in our setting [12].…”

LITERATURE REVIEW: Hubungan Diabetes Mellitus Gestasional Dengan Kelahiran Prematur

“…Bayi baru lahir kasus lebih banyak dirawat di NICU daripada bayi wanita kontrol (p = 0,05). (17) Berdasarkan regresi logistik ganda, primigravida memiliki kemungkinan >32 kali mengalami persalinan prematur dibandingkan multigravida (RO = 32,464), wanita hamil dengan gangguan hipertensi pada kehamilan >14 kali lebih mungkin mengalami persalinan prematur (RO = 14,241), wanita hamil dengan perdarahan antepartum selama kehamilan ini >13 kali lebih mungkin mengalami persalinan prematur (RO = 13,181), wanita hamil dengan riwayat kehamilan sebelumnya kelahiran prematur >11 kali lebih mungkin mengalami persalinan prematur (RO = 11,708). Wanita hamil dengan riwayat operasi ginekologi >7 kali lebih mungkin mengalami persalinan prematur (RO = 7,171).…”

“…Walaupun demikian, penelitian ini juga memiliki kekurangan di mana data pada penelitian ini didapatkan dengan cara wawancara tatap muka terhadap subjek penelitian menggunakan kuesioner sehingga kemungkinan recall bias tinggi. Selain itu, jumlah sampel penelitian ini terbatas sehingga tidak mampu menggambarkan kondisi populasi yang sebenarnya (17). Pada penelitian ini, subjek penelitian dibagi 2 kelompok sesuai usia kehamilan.…”