TITLE:
Profiling the Socio-Demographic Characteristics and Outcome of Preterm Delivery in Alex Ekwueme Federal University Teaching Hospital Abakaliki
AUTHORS:
Malachy Chizoba Onyema, Vitus Okwuchukwu Obi, Johnbosco Ifunanya Nwafor, Chinwe Wendy Oliobi, Bridget Nkiruka Uche-Nwidagu, Assumpta Nnenna Nweke, Paschal Chijioke Okoye
KEYWORDS:
Preterm Delivery, Maternal Sociodemographic Characteristics, Neonate
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.8,
August
21,
2019
ABSTRACT: Background: Preterm delivery is a major cause of perinatal morbidity and mortality
globally. In more than half of the cases, the exact cause is unknown and it is
largely unpredictable. Certain maternal, social and demographic characteristics
are risk factors and often help to predict and prognosticate the neonatal
outcomes. Objective: This study was designed to determine the maternal socio-demographic
characteristics and neonatal outcomes of patients managed for singleton preterm
delivery in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Method: This was a 4-year retrospective analysis of patients managed for
preterm birth from 1st January 2012 through 31st December
2015. Results: Over the study period there were a total number of 623 singleton
preterm deliveries in the facility, while there were 9647 deliveries in the
facility; the preterm birth rate was 6.5% or 65 per 1000 deliveries. The mean
maternal age was 28.79 ± 5.33 while the mean parity was 1.89 ± 1.98.
The mean gestational age and birth weight were 33.67 ± 2.62
and 2.30 ± 0.78 kg respectively. Apgar score in 1 minute
was 6.89 ± 3.27, while in the 5th minute was 7.95 ± 3.42.
Majority of the patients were multiparous and booked for antenatal care in the
facility. Most of the preterm labour started spontaneously and were delivered
vaginally. The caesarean section rate in this study was 35.5%. Fetal distress
and preeclampsia/eclampsia were the commonest indications for caesarean
section. The male to female ratio was 1.1:1. Nearly half of the neonates were
born with normal birth weight and 427 (68.5%) were alive at discharge. However,
196 (31.5%) suffered early neonatal death due to prematurity. Maternal parity,
booking status and fetal weight were significant determinants of fetal outcome
with a p-value 0.05. Conclusion: Birth weight was the most important determinant of neonatal survival and
the unbooked patient was an important determinant of poor outcome. Booking for
antenatal care and ensuring optimal weight at delivery would go a long way at
reducing the poor neonatal outcome associated with preterm delivery.