Prevalence and factors associated with preterm birth at Kiryandongo general hospital
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Date
2018-04
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Kampala International University. School of Health Sciences Western Campus
Abstract
Background: The World Health Organization (WHO) estimates the prevalence of preterm birth to be between 5% and 18% across 184 countries. Of the estimated 3 million neonatal deaths occurring globally each year, about 1 million are directly related to prematurity. Uganda has one of the highest preterm birth rates in the world estimated at 13.6 per 1000 live births and little was known about prevalence of preterm birth in Kiryandongo hospital. In order to realize a reduction in pre-term births,
interventions that target the risk factors are paramount. Hence, this study was to explore the prevalence and risk factors of preterm birth in Kiryandongo general hospital. All mothers who had live births at Kiryandongo Hospital and their newborns were included in the study. Mothers were interviewed using a standard pretested questionnaire to identify factors associated with preterm birth. Data was analyzed using excel analysis package version 2016 and a pvalue < 0.05 was considered significant .A total of 154 mother-baby pairs were enrolled into the study. The mean maternal age was 26±5 years while most mothers (83%) were married and had attained primary level of education or below (85%). The prevalence of preterm birth in this study was found to be 18.3% (95% CI of 14.1- 22.5). Parity ≥ 4, previous preterm birth, multiple gestation, pregnancy induced hypertension (PIH), antepartum hemorrhage (APH), prolonged preterm prelabor rupture of membranes (PPROM) and
urinary tract infection (UTI) in pregnancy were all significantly associated with preterm birth (p=<0.05). On logistic regression, only PIH, APH and prolonged PPROM remained significant. Marital status, maternal level of education, smoking, alcohol use in pregnancy, maternal occupation, ANC attendance, HIV status, anaemia and interpregnancy interval were not associated with preterm birth. APH and parity ≥ 4 were more associated with early than late preterm (OR=4.7 versus 1.7 and OR=6.2 versus 3.9 respectively) while those who had multiple gestation had an almost 7 fold risk of delivering late preterms (OR=6.7). Conclusion: The prevalence of preterm birth in Kiryandongo hospital was 18.3%. Parity ≥ 4, previous preterm birth, twin pregnancy, PIH, APH, preterm PROM and UTI were associated with preterm birth. PIH, APH and prolonged PPROM were independent determinants of preterm birth. APH and parity were predictors of early preterm birth while multiple gestation and UTI were strongly associated with late preterm delivery. At-risk mothers should receive intensified antenatal care to lessen preterm
birth.
Description
A research report submitted to the faculty of clinical medicine and dentistry in partial fulfillment of the requirements for the award of a bachelor’s degree in medicine and surgery of Kampala International University
Keywords
Preterm birth, Kiryandongo general hospital