Determinants of preterm birth among women delivered in public hospitals of Western Ethiopia, 2020: Unmatched case-control study

Abstract

Background Worldwide, preterm birth accounts for 1 million deaths of infants each year and 60% of these deaths occur in developing countries. In addition to the significant health consequences on the infant, preterm birth can lead to economic costs. There was a lack of study in western Ethiopia, and most of those studies conducted in other parts of a country were based on card review with a cross-sectional study design. The risk factors of preterm birth may vary from region to region within the same country due to variation in socioeconomic status and health care service coverage. Therefore, this study aimed to identify determinants of preterm birth in western Ethiopia. Methods An institutional-based case-control study was conducted from February 15 to April 15, 2020, in western Ethiopia. The eligible 188 cases and 377 controls were randomly selected for this study. Cases were women who gave birth after 28 weeks and before 37 completed weeks of gestation, and controls were women who gave birth at and after 37 weeks of gestation from the first day of the last normal menstrual period. Data were collected by a structured interviewer-administered questionnaire. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Multivariable logistic regression was used to identify determinants of preterm birth at P-value <0.05. Results From a total of 565 eligible participants, 516 (172 cases and 344 controls) participated in this study with a response rate of 91.3%. The result of the multivariable analysis shows that mothers who developed pregnancy-induced hypertension (AOR = 3.13, 95% CI; 1.78, 5.50), only one time ANC visits (AOR = 5.99, 95% CI; 2.65, 13.53), experienced premature rupture of membrane (AOR = 3.57, 95% CI; 1.79, 7.13), birth interval less than two years (AOR = 2.96, 95% CI; 1.76, 4.98), developed anemia during the current pregnancy (AOR = 4.20, 95% CI; 2.13, 8.28) and didn’t get dietary supplementation during the current pregnancy (AOR = 2.43, 95% CI; 1.51, 3.91) had statistically significant association with experiencing preterm birth. Conclusion Antenatal care service providers should focus on mothers with pregnancy-induced hypertension, premature rupture of membrane, and anemia during pregnancy, and refer to the senior experts for early management to reduce the risk of preterm delivery. Antenatal care services such as counseling the mother on the benefit of dietary supplementation during pregnancy, antenatal care follow up, and lengthening birth interval should be integrated into the existing health extension packages. New and inclusive strategies such as the establishment of comprehensive mobile clinic services should also be designed to reduce the burden of preterm birth among women living in the rural community. Lastly, we recommend future researchers to conduct longitudinal and community-based studies supplemented with qualitative methods.

Adverse obstetric outcome and its associated factors in public hospitals of North Ethiopia: does parity make a difference?

“…Women with preterm deliveries were nine times at higher risk of adverse obstetric outcomes. This finding was supported by a study done in Western Ethiopia, where mothers who developed anemia during pregnancy, PROM, and PIH were more likely to experience preterm birth [ 25 ]. Anemia may induce maternal and fetal stress and increase the risk of maternal infection stimulating the production of corticotropin-releasing hormone (CRH).…”

Evaluation of the association between haemoglobin levels and preterm birth at Khartoum, Sudan: A hospital-based study

“…More than three-quarters (81.1%) of all PBs occur in Africa and South Asia (2). PB is a major Elmugabil et al 10.3389/fnut.2022.933557 cause of perinatal death and a significant cause of longterm consequences among the survivors (3). PB is the main direct cause of neonatal death and is associated with 50-75% of all neonatal mortality and half of all neonatal morbidity worldwide (4).…”

“…Risk factors for PB should be correctly identified and properly managed to reduce the incidence of PB. Maternal nutrition may impact both haemoglobin synthesis and foetal growth, development, survival, and PB (10,11). Previous studies on the association between the haemoglobin level and PB showed inconsistent results.…”

Nutritional-Related Predictors of Preterm Birth in North Shewa Hospitals, Central Ethiopia: A Case–Control Study

“…It is consistent with study conducted in British and South Ethiopia where any additional dietary supplementation is associated with preterm birth. 17 , 31 The reason behind this fact is during pregnancy women need additional meals for themselves, their fetus, and pregnancy outcomes. 32 If pregnant women do not get additional food, then they can face malnutrition (thinness).…”

“…6 Some of the risk factors of preterm birth are undernutrition, obesity, anemia, unable to obtain dietary supplements, not consuming vegetables, and low maternal weight, low income. 5,[10][11][12][13][14][15][16][17] Although the fact that eating patterns throughout pregnancy have a critical role in the health of both the mother and the baby and pregnant women have to eat variety of food in addition to taking additional food; nutritional-related predictors of preterm delivery have yet to be examined. [18][19][20] Despite the high prevalence of preterm birth in Ethiopia, which causes a variety of morbidities and mortality in mothers and babies, as well as economic losses, no research has been done on nutritional-related predictors of preterm delivery.…”