Maternal Risk Factors for Singleton Preterm Births and Survival at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Abstract

Context: Risk factors for and survival of singleton preterm births may vary according to geographical locations because of socioeconomic differences and lifestyle.

Aims: The aim was to describe maternal risk factors and survival‑to‑discharge rate for singleton preterm births at the University of Nigeria Teaching Hospital and determine the relationship between maternal risk factors and the survival of singleton preterm babies.

Subjects and Methods: A comparative retrospective review of singleton preterm and term births from January 2009 to December 2013 was carried out. Statistical analysis involved descriptive and inferential statistics at 95% level of confidence using the Statistical Package for Social Sciences (SPSS) version 15 for Windows. P ≤ 0.05 was considered significant.

Results: A total of 784 births including 392 singleton preterm births (aged 26 − 36 + 6) and 392 singleton term births were studied. The mean age of mothers who delivered singleton preterm babies did not differ significantly from that of mothers who delivered singleton term babies (30.2 ± 4.9 years vs. 30.8 ± 4.7; P = 0.06). Lack of antenatal care (adjusted odds ratio [aOR] = 2.63; 95% confidence interval [CI] 1.92, 6.07), Previous preterm birth (aOR = 5.06; 95% CI: 2.66, 9.12), having pregnancy complications including antepartum hemorrhage, preeclampsia/eclampsia or premature rupture of membranes (aOR = 5.12; 95% CI: 2.4, 11.8), being unmarried (aOR = 2.41; 1.56, 3.71) and nulliparity (aOR = 2.08, 95% CI: 1.22, 4.91) were independent risk factors for singleton preterm births. The average survival‑to‑discharge rate for preterm babies during the period was 38.4%. The mean duration of admission for singleton preterm babies was 16 ± 5.8 days (range: 2−75 days). Whereas survival was dependent on, gestational age at birth (P < 0.001) and mode of delivery (P = 0.01), it was not dependent on maternal risk factors of parity, marital status, complications of pregnancy, and antenatal care.

Conclusions: There was a low rate of survival of singleton preterm babies at the study center and survival was dependent on gestational age at birth and mode of delivery, but not on maternal sociodemographic risk factors for singleton preterm births. Active collaboration between the obstetrician and the neonatologist in deciding when and how to deliver these babies may provide improved chances of survival.

Keywords: Births, Preterm, Risk Factors, Singleton, Survival