Clinical and sociodemographic correlates of preterm deliveries in two tertiary hospitals in southern Nigeria

Abstract

Background: To determine the prevalence of preterm delivery and identify the associated risk factors.

Design: This was a five – month prospective case control study of two cohorts of women who had preterm and term deliveries.

Setting: Central Hospital (CH), Warri, and Delta State University Teaching Hospital (DELSUTH), Oghara, respectively in southern Nigeria.

Participants: 522 women which consisted of 174 who presented in preterm labour or with preterm prelabour rupture of membranes as cases and 348 parturient with term deliveries served as controls.

Interventions: The study was conducted from May 1st 2015 to September 30th 2015. Socio – demographic characteristics, past gynaecological/obstetric factors, maternal/obstetric factors, and fetal outcomes were compared, and associations between these variables and gestational age at delivery were determined.

Main outcome measures: Prevalence of preterm delivery associated clinical and socio-demographic correlates and the fetal salvage rates.

Results: The incidence of preterm birth was 16%. Maternal age (p < 0.002), parity (p < 0.000), booking status (p < 0.000), and socio – economic class (p < 0.000) were significantly associated with preterm births. Others were multiple pregnancy (p < 0.000), pre – eclampsia/eclampsia (p < 0.000), anaemia (p < 0.000), malaria (p < 0.000), UTI (p < 0.012), premature rupture of membrane (p < 0.000) and antepartum haemorrhage (p < 0.000). Fetal salvage rate was zero for extreme preterm neonates and 100% at late preterm.

Conclusion: Preterm birth was common, with well-defined correlates and predictors. The fetal salvage rates were significantly different across the categories of preterm neonates.

Funding: The study was self-funded by the authors

Keywords: preterm, gestational age, parity, Nigeria, risk factors, pregnancy, prevalence