Prevalence of Preterm Neonates and Risk Factors

Introduction Preterm birth is defined as delivery before 37 completed weeks (WHO). The issue of preterm birth is still a major health problem in the world; 75% of neonatal mortalities are due to prematurity.(1,3) A variety of morbidities are significantly increased in preterm neonates who survive. Morbidity in multiple organs such as respiratory tract, cardiovascular, GI, metabolic, neurological and urinary system is much more common in premature neonates compared with those delivered at ter.(4) So, most pediatricians believe, prevention of preterm birth is obviously logical and important, and it seems necessary to diagnose the risk factor of preterm birth. Approximately half of preterm births occur idiopathically. Other factors responsible for preterm birth are: fetal, uterine and placental factors, maternal chronic disease, PROM, polyhydramnios, social problems such as cigarette, alcohol and maternal emotional or physical stress.(5) In a study by Burke6 in Ireland (2000), preterm labor, multifetal pregnancies and HTN were the major factors related to preterm birth. In a study in Latin America (1985-2003) by Barros7, PROM was the most common (60%) finding related to 1,700,000 preterm birth. In a survey by Rawlings(8) in USA (1995), the interval between pregnancies, was studied in Introduction Preterm birth is still a major health problem throughout the world. Preterm birth results in 75% of neonatal mortality. We sought to identify risk factors which cause preterm birth. Materials and Methods This cross-sectional study assessed all preterm neonates born in Asali Hospital in Khorram Abad (either by NVD or C/S) during the first 6 months of 2007. Sampling method was census. Fetal sex, maternal disease, maternal addiction to cigarettes, maternal age, placental problems, number of gravidities, PROM, preeclampsia, multifetal gestation, Apgar score, uterine anomaly were the variables studied in this survey. Questionnaires were used to collect the data and the data was analyzed with SPSS software. Results 183 of 2179 live neonates borne in Asali hospital were preterm (8.4%). The most common factors related to preterm birth were: Primigravidity(56.3%), PROM(35.5%), preterm labor pain(33.8%), maternal disease(22.4%), preeclampsia(21.9%), multifetal gestation(19.7%), previous abortion(18.6%), previous preterm delivery(9.8%), high risk maternal age(10.4%) and placental problems(7.7%). Preterm labor pain was significantly more common among multiparus women in comparison with nulipara ones(x2=16.5, p=0.000049) but occurrence of PROM(x2=0.57, p=0.45), preeclampsia(x2=0.8, p=0.37), maternal chronic disease(x2=0.55, p=0.46) and multifetal gestation(x2=0.01, p=0.91) was not significantly different among multipara and primipara women. Conclusion Several factors related to preterm birth can be prevented by health modalities. Maternal education and giving advanced information to mothers in prenatal health care visits, preterm birth and its side effects may be reduced.