Maternal risk Factors for Pre-Term Delivery in Lagos

Abstract

Background: Pre-term birth (before 37 completed weeks) is an important cause of perinatal and neonatal morbidity in Nigeria and the world at Large.
Objective: This study was to determine the maternal risk factors associated with per-delivery in Lagos.
Methods: A structured questionnaire was administered to 100 consenting consecutive women who had pre-term deliver (cases) and 100 women who had term delivery during the same period (control), at the Lagos University Teaching Hospital.
Results: Age and parity were not significant risk factors. Significant risk factors were maternal height <1.55m (OR 3.24, 95% CI 1.42-7.32, p<0.01), social class IV (Or 2.23, 95%, CI 1.08 – 4.62, p<0.04), and lack of antenatal care (OR 7.98, 95% CI 2.17-29, 40. p<0.0001). Antenatal care in small maternity units (OR 4.43, 95% CI 2.12- 9.27, p<0.001) increased risk of pre-term birth while that in a tertiary hospital decreased risk (OR 0.14, 95% CI 0.07-0.24, p<0.001). Malaria and other febrile illness (OR 5.97, 95% CI 2.65-13.43, p<0.001), Antepartum haemorrhage (Or 4.92, 95% CI 1.73-13, p <0.001) and hypertensive disease (OR 6.47, 95% CI 301- 13.91, p,0.001) increased risk of pre-term birth.
Previous pre-term birth (OR 5.49, CI 0.99-18, 40, p<0.01) and 3 or more previous terminations of pregnancies (OR 3.89, 95% CI 0.69-10.41, p<0.01) increased risk, while HIV infection, anaemia, and sickle cell disease were not significant risk factors.
Conclusion: Most of the risk factors for pre-term birth in this study are preventable. Provision of adequate, accessible and affordable antenatal care and family planning services would reduce the incidence of pre-term births in Nigeria.


NQJHM Vol. 13 (3-4) 2003: pp. 6-10