FACTORS ASSOCIATED WITH INDICATED PRETERM BIRTH AND OUTCOME OF PRETERM BIRTH IN SPHMMC FROM SEPTEMBER 1, 2015 TO SEPTEMBER1, 2016.

Abstract

Abstract The birth of a preterm infant results in significant health consequences to the infant and emotional and economic costs for families and communities. Approximately 70 to 80 percent of preterm births occur spontaneously and the remaining 20 to 30 percent of preterm births are medically indicated because of maternal or fetal issues. About 75% of perinatal deaths and 50% of neurological abnormalities are directly attributed to preterm. The aim of this study is to identify the common risk factors associated with indicated preterm birth and its immediate outcome which indicates ways to decrease its occurrence and associated death which contributes to significant neonatal mortality rate. Methodology: An institutional based analytic and descriptive retrospective study was conducted. Total sample size of 208 medical charts was used and systematic sampling technique was used to select study units. The study was done in SPHMMC NICU. The data was entered and analyzed with SPSS version 22. Both univariate analysis and binary logistic regression was done. Result: Among the preterm birth 68.8% were spontaneous preterm birth and 31.3% were indicated preterm birth. Indicated preterm births had an odds of being born to HIV mothers that are 7.250 times the odds of those Spontaneous preterm birth ( P=0.037, AOR=7.250, 95% 1.122,46.850). Those mothers having preeclampsia with severity feature more likely (P=0.031,AOR=39.27, 95% CI: 14.21,108.50) give indicated preterm birth and less likely (P=0.000, AOR=0.026, 95% CI: 0.010,0.072) to give spontaneous preterm birth. Those mothers with Chorioamnionitis were more likely (P=0.017, AOR=5.444, 95% CI: 1.364,21.894) to give indicated preterm birth and less likely (P=0.023, AOR=0.205, 95% CI: 0.052,0.808) to give spontaneous preterm birth. Preterm neonates who were discharged dead had odds of having RDS that are 22 times odds of those discharged alive (p=0.004, AOR= 22.08, 95%CI: 2.708,180.072). Conclusion: Maternal HIV infection, preeclampsia with severity feature, Chorioamnionitis, partial HELLP was found to have significant association indicated preterm birth. RDS showed significant association with death outcome of the neonate.