[Preterm births at Brazzaville University Hospital]

The objectives of our study were to assess the frequency, causes and outcomes of preterm births in Brazzaville University Hospital and to improve our obstetric and pediatric management. We retrospectively studied all births during 1994: 5109 in all. We collected information about the circumstances of preterm birth and all available information about its causes, mode of delivery, and immediate 24-h outcome. There were 852 preterm births (16.7% of all births). Mothers aged 14-20 years accounted for 27% of these births, while those 35 years or older accounted for only 9%. The 24-h survival rate was 73.7% (n=628). Those born at a gestational age of 28-30 weeks accounted for 40.7% of the deaths. The principal causes in order of frequency were: premature rupture of membranes (48%, caused by infection in 68% of cases), complications of high blood pressure (23.9%, including eclampsia, abruptio placentae and HELLP syndrome), twin pregnancies (14%), and previa placenta and hemorrhage (7%). The average time until the baby's transfer to neonatal intensive care was 12 hours, often because of an absence of beds. The principal causes of such transfer were: neonatal infection (48%), respiratory distress (27%) and gestational age less than 33 weeks (22%). Prognosis for preterm births is better at Brazzaville University Hospital at and after 33 weeks; extreme prudence is required before this term, especially for cesarean deliveries.