Obstetric determinants of preterm delivery in a regional hospital, Accra, Ghana 2016
Loading...
Date
2019-07-08
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Pregnancy and Childbirth
Abstract
Background: Globally, prematurity is a major determinant of morbidity and mortality contributing 30–40% of
neonatal mortality. The consequences of preterm deliveries are enormous with developmental and childhood
complications as well as high economic and psycho-social burden on the parents (family) and society. Some risk
factors include ever having preterm delivery, multiple births and some medical conditions like sexually transmitted
infection and urinary tract infections but these have not been ascertained in our study area. Much research into
these risk factors is needed in Ghana. We assessed the obstetric determinants of preterm delivery.
Methods: We conducted a 1:2 unmatched case-control study in Greater Accra Regional Hospital (GARH) -Ridge, a
secondary referral facility in Accra, Ghana (from October, 2015 -May, 2016). A case was a mother who delivered
between 28 and 36 weeks of gestation (preterm) and a control was a mother who delivered after 37 to 42
completed weeks (term). We used structured questionnaire to collect data, reviewed maternal and foetal records
using a checklist. Categorical variables were analysed and expressed as frequencies and proportions. We
determined the association between obstetric factors and preterm delivery with multiple logistic regression.
Significance level of the strength of association was determined at 95% CI and p-value < 0.05.
Results: We recruited 390 mothers, 130 had preterm deliveries (cases) and 260 had term deliveries (controls). Experiencing
premature rupture of membrane (aOR: 2.3; 95% CI:1.0–5.5), pre-eclampsia/eclampsia (aOR: 3.4; 95% CI: 1.0–11.9) were found
to be associated with preterm delivery. However, four or more ANC visit was protective factor for preterm delivery (aOR: 0.2;
95% CI: 0.1–0.4).
Conclusion: Premature rupture of membrane, hypertensive complications and antepartum haemorrhage were found to
be risk factors associated with preterm delivery in Ridge Hospital. Health workforce providing ANC services need to identify
risk factors and refer these mothers to the doctor for early management and improved outcome decreasing preterm
delivery.
Description
Research Article
Keywords
Preterm delivery, Unmatched case-control, Obstetric factors