TITLE:
Maternal Risk Factors and Short Term Outcome of Prematurity: A Descriptive Study at a Secondary Care Hospital
AUTHORS:
Heeramani Lohana, Shakeel Ahmed, Nigar Jabeen, Farida Kareem, Sarwat Urooj, Ayesha Ahmed
KEYWORDS:
Preterm Birth, Risk Factors, Neonatal Morbidity
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.10 No.3,
September
8,
2020
ABSTRACT: Background: Approximately
15 million babies are born premature (before 37 weeks of gestation) and 1 million
babies die due to prematurity complications every year. Less is known about risk
factors of prematurity in middle and low-income countries. The prevalence of
prematurity ranges from 5% - 18%. Objective: To determine the prevalence
of premature births and to assess the rate of survival, along with the
morbidity, among preterm newborns. Furthermore, to document our experience with
different gestational age groups of preterm births; and to analyze the
association among these strata and their clinical outcomes. Study Design: A descriptive study. Place and Duration of Study: The Aga Khan Maternal
and Childcare Centre Hyderabad, Pakistan, from 1st January 2017 to
31st December 2018. Methodology: All pregnant women
registered at the obstetric clinic before 24 weeks of gestation having at least
three subsequent visits at the same clinic were included in the study. The
women who were lost to follow up before completing three visits were excluded
from the study. All un-booked women were also excluded from the study.
Demographic profile was recorded including maternal age, parity, no of visits
at the clinic, gestational age, mode of delivery, birth weight and pregnancy
outcome. Newborns were subsequently followed at nursery or well-baby till
discharge. Further subgroups were made for gestational age to assess the frequency
of various morbidities in each group. Results: One thousand and ninety-one
(1091) women were included in the study period that fulfilled the inclusion
criteria. Two pregnancies were terminated before 24 weeks due to major congenital
malformations. The prevalence of prematurity was recorded as 13.4% (146/1089). Perinatal
mortality rate (no of stillbirths plus the number of early neonatal death/1000
live birth) was 17 (15.6/1000 live births) out of them, 12 were still births and
5 were early neonatal death. Out of the total preterm babies born, 59.5% (87/146)
were admitted to the nursery. In the study group (2%/3146) were extreme preterm,
while 7.5% were severe preterm (11/146). Moderate preterm was 11.6% (17/146) and
the majority were late preterm accounting for 78.7% (115/146). Though the incidence
of birth asphyxia were noted more in late preterm babies i.e. 10 as the number of these babies are also high in our study but
the overall percentage was low (8.7%) as
compared with the babies of extreme prematurity (100%) and moderate late
prematurity (23.5%) respectively. In pregnancy outcome, 12 were still births in
which six (50%) were in the late preterm group. Total of 17 newborns suffered
from birth asphyxia in which ten newborns (58.8%) were in late preterm group. Overall,
it was noted that the decreasing gestational age was directly correlated to
morbidity and mortality. Conclusion: Among the different strata, the
late preterm group has been observed to be associated with greater morbidity
and mortality. Prior awareness of the morbidities associated with late preterm
babies is helpful for the health care providers to anticipate and manage
potential complications in preterm infants.