Prevalence and Factors Associated with Spontaneous Preterm Birth at the University Teaching Hospital, Lusaka Zambia

Abstract

Objectives: To investigate the prevalence, sociodemographic and maternal factors associated with spontaneous preterm birth in women delivering at the University Teaching Hospital, Lusaka.

Methods: This was a cross-sectional study on postnatal women delivering at UTH Lusaka. Between 1st February 2018 and 31st august 2018, a structured questionnaire was used to collect data on socio-demographic, past and present medical and obstetric history. Babies were physically  examined to assess for gestational age using the Finnstrom scoring. A sample size of 210 women was collected out of which 105 had preterm and 105 term deliveries. The risk of spontaneous preterm birth was estimated with OR and 95%CI for several predictors. A logistic regression analysis was then performed to identify independently associated factors.

Results: The mean gestation age was 33.1weeks and 39.4 weeks respectively for preterm and term pregnancies. Of the preterm births, 48 (45.7%)  were ranged between 34+0 and 36+6 weeks. Four babies were born with a weight 1000gr and 58 (52.3%) with weight between 1500-2499gr. The prevalence of spontaneous preterm birth was 7.7%. On multivariate analysis, age was not associated with preterm birth (p=0.06). Single status was (OR :2.65, p=0.001), low education level (OR:3.85, p=0.03), low family income (OR: 7.75, p=0.025) and.549 alcohol intake (OR:2, P=0.006) were  significantly associated with preterm birth. For the maternal factors, Parity was not associated with preterm birth (p=0.878). However, gestational age of less than 20weeks at booking was protective (OR: 0.485, P=0.013). A few antenatal visits was significantly associated with preterm birth (OR: 8.06, P<0.001)

Conclusion: Spontaneous preterm birth remains a major problem at UTH Lusaka with the prevalence of 7.7%. Being single, low education level, low family income, occasional alcohol drinking and fewer antenatal visits were significantly associated with preterm birth. However, early booking at less
than 20 weeks was protective.