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A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
A cohort study on risk factors for preterm births in rural Gujarat
Poonam Trivedi1, Deepak Saxena2, Tapasvi Puwar3
1Senior Research Assistant, Indian Institute of Public Health, Gandhinagar, Gujarat, India.
Insights
Preterm birth (PTB) affects infant mortality globally. This study identified periodontal disease, longer sleep duration, and sexual activity during pregnancy as significant risk factors for PTB in India.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Public Health Research
Background:
- Preterm birth (PTB) is a major cause of neonatal and under-five mortality in India and globally.
- PTB contributes to significant short- and long-term infant morbidities.
- Many PTB risk factors remain unexplained, necessitating community-based research in high-burden regions like India.
Purpose of the Study:
- To investigate and identify various risk factors associated with preterm birth (PTB).
Main Methods:
- A cohort of 1977 antenatal mothers was enrolled and followed in Gujarat, India.
- Data on pregnancy outcomes and potential risk factors were collected using structured questionnaires.
- A hierarchical regression model was employed to analyze risk factors for PTB.
Main Results:
- The study observed a 9% proportion of preterm births (PTBs) within the enrolled cohort.
- Significant risk factors identified included periodontal disease, prolonged sleep duration, and sexual activity during any trimester.
- These findings highlight specific, modifiable factors contributing to PTB.
Conclusions:
- There is an urgent need for enhanced, evidence-based interventions to prevent PTB.
- Routine antenatal care should include screening for oral hygiene due to the link with PTB.
- Promoting good oral hygiene practices for pregnant women is recommended.
Background:
Prematurity is one of the leading causes of neonatal and under-five mortalities globally and also in India. It is an important determinant of short- and long-term morbidities in infants and children. Unfortunately, risk factors of majority of preterm births (PTBs) remain unexplained which calls for appropriate action. There is a dearth of community-based research on PTB and its risk factors, especially in high burden countries like India.
Objectives:
The objective of the study was to explore different risk factors for PTB.
Methods::
A cohort of 1977 antenatal mothers was enrolled at household level by trained field investigators and was followed up in four districts of Gujarat, India, to document the outcome of pregnancy. Pretested and structured questionnaires were used to collect information. A hierarchical regression model was used to analyze the risk factors for PTB.
Results:
Proportion of PTB was 9% among the enrolled cohort. Risk factors which were found to be significant on applying the hierarchical model were periodontal disease, long sleep duration, and sex during any trimester.
Conclusions:
The study suggests an urgent need for strengthening of existing guidelines for effective, evidence-based, and culturally appropriate interventions for prevention of PTB. Maintenance of good oral hygiene should find a place in routine recommendations for pregnant women, and antenatal examinations should include screening for oral hygiene also.
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