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Published on: January 12, 2018
Prevalence of preterm birth and perinatal outcome: A rural tertiary teaching hospital-based study
Ke Manga Reddy1, Shilpa Rani Ravula1, Shruthi Palakollu1
1Department of Obstetrics and Gynecology, Mediciti Institute of Medical Sciences, Ghanpur, Medchal, Malkajgiri, Telangana, India.
Insights
Preterm birth affects 10.86% of deliveries, with significant risk factors including previous preterm birth, hypertension, and multiple pregnancies. Addressing modifiable risks can improve outcomes for preterm infants.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Health
- Public Health
Background:
- Preterm birth (before 37 weeks) is a critical global health issue, causing significant perinatal mortality and long-term morbidity.
- It is a leading cause of death in children under five, with 75% preventable by cost-effective interventions.
Purpose of the Study:
- To determine the prevalence of preterm birth.
- To identify associated risk factors in women delivering at a rural tertiary hospital.
- To assess the impact of preterm birth on perinatal outcomes.
Main Methods:
- A retrospective case-control study was conducted from January to December 2019.
- Data from 135 preterm births (cases) and 248 term births (controls) were analyzed.
- Statistical analysis included odds ratios and confidence intervals to identify significant risk factors.
Main Results:
- The preterm birth prevalence was 10.86%.
- Significant risk factors identified: previous preterm birth (OR=4.88), previous LSCS (OR=2.16), short interpregnancy interval (OR=2.78), hypertension (OR=3.10), PROM (OR=0.73), oligohydramnios (OR=3.58), and multiple pregnancy (OR=24.09).
- Neonatal intensive care unit (NICU) admission rate was 52%, with satisfactory neonatal outcomes.
Conclusions:
- Several risk factors for preterm birth are modifiable.
- Implementing preventive strategies targeting hypertension, oligohydramnios, and improving overall maternal healthcare quality can reduce preterm birth prevalence and improve outcomes.
Context:
Preterm birth is defined as births before 37 weeks of gestational age. Preterm birth is a major challenge in obstetric health care and leading cause of perinatal mortality and long-term morbidity. Complications arising from preterm births are the leading cause of deaths among children less than 5 years of age. Seventy-five percent of them could be saved with current, cost-effective interventions. The rate of preterm births worldwide is 5-18% with the developing countries accounting for the maximum deaths.
Aims:
This study was undertaken to evaluate the prevalence of preterm births and risk factors associated with it among women delivered at a rural tertiary teaching hospital in Telangana and further assess its impact on perinatal outcome.
Settings And Design:
This was a retrospective case control study conducted at Mediciti Institute of Medical Sciences from January 2019 to December 2019.
Methods And Material:
Of the 1243 deliveries during the study period, 135 births that occurred at <37 weeks were taken as cases and 248 term neonates were taken as control group. Data were collected retrospectively through review of prenatal and hospital delivery records.
Statistical Analysis Used:
Data were collected and tabulated as shown in the results. Statistical analysis was done using Microsoft Excel. Frequency and percentage of each parameter were calculated and analyzed. The risk estimates were analyzed between the cases and controls by calculating the odds ratio, 95% confidence interval, and P value. P Value of <0.05 was considered significant.
Results:
The prevalence rate of preterm birth was 10.86%. History of previous preterm birth (OR = 4.88, C.I: 1.50-15.87, P = 0.0084), previous LSCS (OR = 2.16, C.I: 1.36-3.44, P = 0.001), inter-pregnancy interval <12 months (OR = 2.78, C.I: 1.13-6.84, P = 0.026), hypertension (OR = 3.10, C.I: 1.78-5.42, P = 0.0001), PROM (OR =0.73, C.I: 2.36-9.49, P < 0.0001), Oligohydramnios (OR = 3.58, C.I: 1.29-9.9, P = 0.01), and multiple pregnancy (OR = 24.09, C.I: 3.09-187.46, P = 0.0024) were found to be significant risk factors for preterm birth. Though the NICU admission rate was high (52%), neonatal outcome was found to be satisfactory.
Conclusions:
Some of the risk factors that contributed to preterm birth were modifiable. Preventive strategies addressing the risk factors such as hypertension, oligohydramnios, and also improving health care quality to pregnant women will reduce the prevalence of preterm births and outcomes.
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