DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20175259

A retrospective analytical study of the epidemiology and causes of preterm birth

Shehla Jamal, Ruchi Srivastava

Abstract


Background: Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. The main cited reasons for this trend are increasing indicated preterm births and rising rates of artificially conceived pregnancies. Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy.

Methods: This is a retrospective analytical study, done in the department of Obstetrics and Gynecology over a period of two years (January 2015-December 2016). All singleton preterm live births were included in the study. The records of all the included patients were studied from the medical records department of the hospital, after obtaining permission for the same. The results were analysed and obtained by percentage method.

Results: A total of 2564 pregnancies were analysed in present study. The number of preterm deliveries was 436 in two years. Out of 2564, the number of live births was 2365, making an incidence of 18.4%. Maximum preterm deliveries were observed in the teenage group (27%) and elderly gravidas (23.9%), both the groups falling into high risk categories for preterm birth. Multiparity was an independent risk factor observed in our study and was found to be associated with 47.5% cases. Level of antenatal care received was also directly related to the number of preterm deliveries. As high as 58.4% of the females landed into preterm birth, who never sought antenatal care, the commonest risk factor for preterm birth was PPROM (26.6%) followed by hypertensive disorders of pregnancy (18.6%). We observed a labor induction rate of 23.4% and Caesarean delivery was performed in 146 (33.5%) cases, thus indicating a high induction and caesarean rates in such pregnancies.

Conclusions: Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.


Keywords


Indicated preterm deliveries, Neonatal morbidity, Neonatal mortality, Preterm birth

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References


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