Prevalence and Factors Associated With Premature Deliveries at Pumwani Maternity Hospital From January 2017 to December 2022

Abstract

Preterm birth refers to births before 37 complete weeks since the first day of a woman’s last menstrual period. According to a World Health Organization study, the rate of premature births in Africa is 14.1%. The study also found that the Central African Republic had the highest rate of premature deliveries (19.4%), followed by Somalia (18.9%), and Guinea-Bissau (18.3%). The Kenya Demographic and Health Survey (KDHS) shows that teenage mothers have a preterm birth rate of 14.6%, which is almost double the overall rate. This underscores the necessity for targeted interventions to decrease the frequency of preterm births in this susceptible population. Objective: To determine the prevalence of premature births and risk factors associated with them at Pumwani Hospital, Kenya. Methods: This was a hospital-based cross-sectional study. It was conducted in the newborn section at Pumwani Maternity Hospital (PMH). The study population comprised records of women of reproductive age who delivered in the hospital within the study period. A total of 600 records were recruited in this study. Data analysis was carried out in R version 4.1.2. Categorical variables were summarized using frequencies and proportions. Continuous variables were summarized using medians and interquartile ranges. Factors associated with preterm births were assessed using binary logistic regression. The significance of the tests was interpreted using p values and confidence intervals for odds ratios. Results: The median age of the study participants was 25 years (IQR 23, 30). The majority, 45.3% of the mothers were aged 24 years and below, 26.8% were between 25 to 29 years, and 18% were between 30 to 34 years. The rest were 35 years and above. Of the 600 mothers, 53.7% had a secondary education, 24.8% were primary level and below and 18.5% had a college education. The majority of the mothers, 61.2% were multigravida and the rest were primigravida. The prevalence of premature births was 12% (95% CI 10%, 15%). The number of antenatal clinic visits was significantly associated with preterm deliveries before and after adjustment (P<0.05); 4 visits AOR 0.50 (95% CI 0.30, 0.83) and more than 4 visits AOR 0.11 (95% CI 0.02, 0.38). Conclusion: 1. The prevalence of preterm births among women who delivered in Pumwani Maternity Hospital within the study period was 12.5%. 2. The number of antenatal clinic visits was significantly associated with preterm deliveries before and after adjustment. More visits were associated with lower odds of preterm deliveries. 3. The odds of preterm births varied among the different age groups. Both younger and older women had a higher odds of preterm births. Chronic diseases increased the odds of preterm births. Recommendations: We recommend that healthcare providers stress the need for expectant mothers to attend all the recommended ANC clinics as it has been shown to be protective against preterm births. This is mainly through early identification of high-risk pregnancies and the prevention of premature delivery through medical intervention.