Prevalence of Preterm Birth and Associated Risk Factors in Kakamega County General Teaching and Referral Hospital

Abstract

Introduction: Preterm birth is a global problem and its prevalence has been on the increase worldwide. The Global Action Report for the year 2012 reported prematurity and its complications as the leading cause of mortality in the neonatal period. Study objective: To determine the prevalence and associated risk factors for preterm birth at Kakamega County General Teaching Referral Hospital (KCGTRH). Study design and site: A cross-sectional hospital based study carried out in KCGTRH. Methods: This was a single center descriptive cross-sectional study where the dependent variable was preterm birth and independent variables were assessed for any association as risk factors for preterm birth. There was a total of 230 mothers who were consecutively sampled and enrolled for the study after signing a consent form. A face-to-face questionnaire guided interview was done to determine associated risk factors for preterm birth and it had three sections on sociodemographic, obstetrics and neonatal data. Results: The median age of the mothers interviewed was 25.5 (IQR=8) years. The study showed the prevalence of preterm birth to be at 18.6%. Most of the sociodemographic factors had no significant association with having preterm birth. No education or education level up to primary level (p-0.007 OR-0.4 CI 0.2-0.8) was a risk factor for preterm birth. Inter pregnancy period below two years (p-0.008, OR 0.4 CI 0.2-0.8) and history of pregnancy related medical conditions like hypertension (p-<0.001 OR 0.09 CI 0.03-0.2) were shown to have significant association with preterm birth. Other obstetrics factors that were analyzed and had no significant association with preterm birth in this study were: Parity below 4 and above 4 (p-1.000), history of preterm delivery (p-0.133), history of abortion (p-0.340), prior history of chronic medical conditions (p-0.363), history of infections in pregnancy (p-0.808), MUAC (p-0.065) and hemoglobin level (p-1.000). Conclusion: The prevalence of preterm birth was found to be 18.6% in KCGTRH. The main associated risk factors included no education or education level up to primary level, inter pregnancy level of 2 or below 2 years and history of pregnancy related medical condition like hypertension.