Prevalence, associated factors, and outcomes of singleton preterm births at a Tertiary Hospital in Port-Harcourt, Nigeria

Abstract

Background: Preterm birth poses an important management challenge and is a major public health problem associated with a higher perinatal morbidity and mortality. Although the rates of preterm birth are reportedly high in sub-Saharan Africa, there are little available data on factors associated with preterm birth in this sub-region. Aim: To determine the prevalence, associated factors, and outcomes of preterm births in a tertiary care centre in Nigeria. Materials and Methods: A retrospective case–control study of preterm births, in a two-year period between January 2020 and December 2021, was conducted at the Rivers State university teaching hospital. An unmatched control group of term births was used for comparison. Data were retrieved from the hospital records of all the participants using a structured pro forma. Data were analysed using IBM SPSS version 23 and the significance was set at P < 0.05. Results: Of 3476 singleton birth, 258 (7.4%) were preterm births. Six patients had incomplete data and were excluded from further analysis. Majority, 167 (66.3%), were moderate preterm, gestational age (GA) 32–35. The mean GA at birth was 32.02 ± 2.26 weeks. Majority were aged 31–40 years and parity of 2–4. Stillbirths were 71/252 (28.2%) and 19/101 (18.8%) admitted to the neonatal intensive care unit (NICU) suffered early neonatal death. Preterm birth was more likely in unbooked women, those who developed pregnancy-induced hypertension/eclampsia and following prelabour rupture of membranes (PROM). Babies <32 weeks were more likely delivered by spontaneous vaginal delivery and suffered birth asphyxia. Conclusion: The preterm birth prevalence among singleton gestation was 7.4% and remains a significant factor for perinatal death. Hypertensive disorders of pregnancy, PROM, and lack of antenatal care were identified as risk factors.