Factors associated with preterm birth in KNH
Abstract
Introduction: Preterm birth is an important cause of perinatal morbidity and mortality as
well as increased cost of health care provision in our set-up. Preterm birth is the cause of
at least 7S% of neonatal deaths that are not attributable to congenital malformations, and
causes long-term morbidity and disability for those who survive'. It is, therefore,
important that risk factors be identified to help in preventive management of preterm
birth in KNH.
Objective: To determine risk and outcome factors associated with spontaneous preterm
birth among mothers delivering in KNH labour ward.
Design: This was a hospital-based comparative cross-sectional study.
Setting: Kenyatta National Hospital, Nairobi, Kenya.
Methods: Participants comprised of women delivering in KNH after spontaneous onset
of labour. A structured, interviewer administered questionnaire was used to collect data.
Data was collected over a three month period between June and August, 2009. There was
no matching of the two groups.
Main Outcome Measures: Maternal risk characteristics and feto-maternal outcomes
were compared between women who had preterm birth and those who delivered at term.
Study duration: 15th June and 29th August, 2009
Data analysis: this was done using SPSS version 13. Data entry was done into SPSS and
data cleaning done by use of the questionnaires. Descriptive data was obtained and
further analysis done. P-values, Odds ratios and 95% confidence intervals were
calculated for the various variables under consideration.
Results: 200 women were recruited into the study, 101 in the preterm group and 99 in the
term group. The prevalence of spontaneous preterm birth was 8.7%. There was no
statistical difference between the two groups in socio-demographic characteristics. ANC
attendance was 87.1% in the preterm group and 100% in the term group, which was
statistically significant, p-value<O.OO5. Nineteen percent of the preterm mothers
presented with IUFD as compared to 2% in the term group, p-value <O.OO5,
ORO.09[9S%CI 0.01-0.42] . There was a significant difference between the two groups in
terms of fetal outcomes. There was 100% mortality for infants born with a weight of less
than 1000g.
Conclusion: Pregnant mothers should be encouraged to attend ANC, which may help in
identifying and managing risk factors for preterm labour. There is need to develop cheap
and simple biochemical markers to predict preterm labour.
Citation
Master of Medicine in Obstetrics and Gynaecology of the University of Nairobi,2010Publisher
Department Of Obstetrics And Gynaecology