Assessment of Risk Factors and Its Fetal Outcome of Preterm Birth: In Rural Tertiary Care Hospital, Karad, Maharashtra (original) (raw)
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Evaluation of Risk Factors for Preterm Birth Outcome in Gujarat, India
https://www.ijhsr.org/IJHSR\_Vol.12\_Issue.1\_Jan2022/IJHSR-Abstract.023.html, 2022
Background: Preterm birth (PTB) is a leading cause of neonatal survival complications, mortality, and morbidity worldwide. In India 35% of all neonatal deaths are due to PTB with 36 th global ranking, hence, India's healthcare sector has been working towards reducing the rate of PTB effectively. Objective: This study aimed to assess the risk factors such as environmental and pathophysiological causes associated with preterm birth in the population of Gujarat, India. Materials and Methods: In this study, multivariate random sampling was performed and systematically 200 pregnant mothers [PTB <37 weeks (N=100), Full-term >37 weeks (N=100)] were chosen after excluding mothers with vaginal infection, multiple gestations, fetal anomalies, noncephalic presentation, cesarean delivery, and pregnancy with Mullerian anomalies. Statistical analysis was performed by Chi-square test, and variables with p-value <0.05 were considered statistically significant. Results: Out of all the variables, maternal age below 20 years, extreme BMI, high blood pressure during pregnancy, maternal health complications, medication and doctor's consultation were highly significant (p < 0.0001). Furthermore, variables like type of area, diet, education, Hb levels below 9 g/dL and above 13 g/dL and blood-group of the mother were also significantly associated with PTB outcome (p < 0.05). Among the sub-categories of PTB (extreme-, very-, moderate/late-PTB), maternal age, Hb level and the past obstetric outcome showed very high significance (p < 0.0001). Conclusion: For the prediction of birth outcome, mother's internal physiological and lifestyle factors need to be taken into consideration, and mothers at risk priorly can be screen out, followed by proper healthcare assistance to decrease the preterm birth rate and its consequences.
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.8\_Aug2017/IJHSR\_Abstract.044.html, 2017
Pre-term birth (PTB) is a major determinant of neonatal mortality, morbidity and childhood disability and remains one of the most serious problems. PTB is defined as gestational age at birth of less than 37 completed gestational weeks. It is further classified into three main categories: mild, very pre-term and extremely pre-term for births occurring at 32-36 weeks, 28-31 weeks and less than 28 weeks respectively, with average frequencies of 85%, 10% and 5%, respectively. A retrospective study was conducted on maternal factors for preterm birth. Data was collected from preterm documents (files) at Sri Guru Ram Das Hospital, Amritsar, Punjab. Enumerative sampling technique was used for selection of sample. A self made checklist of maternal factors was used for collecting data. Data included socio-demographic variables of mother and preterm baby, clinical parameters of mother & preterm baby and the maternal factors. Data analysis was done with the use of statistical software SPSS 17.0. The study results revealed that 37.3% (38) of the mothers were having antepartum hemorrhage, 22.5% (23) were having PPROM, 17.6% (18) had abortion history, 16.7% (17) had oligohydramnios, and 13.7% (14) were having pregnancy induced hypertension as factor for preterm birth. Maternal factors found significantly associated with preterm birth were PPROM (F =5.659, p-value=0.001), Twins (F =6.567, p-value=0.000) and Underwent ART (F=2.223, p-value=0.05). Association of maternal factors such as diabetes (p value = 0.000), hypothyroidism (p value = 0.000), drugs before pregnancy (p value = 0.000) and still birth (p value = 0.001) were found significantly associated with socio-demographic variable i.e. religion. Similarly, maternal factor PPROM was found significantly associated (p value = 0.011) with birth weight of baby at p value <0.05.
Infants born between 34 and 36 weeks and 6 days gestation, referred to as late preterm . There is higher incidence of morbidity and mortality in late preterm births. This study was aimed to find out the incidence of late preterm births and to identify mode of delivery, causes, maternal co-morbid conditions and perinatal outcomes. This one year prospective study was conducted on a total of 161 pregnant women who delivered between 34-36 weeks and 6/7 days at Department of Obstetrics and Gynaecology, KLE S Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum from November 2012 to November 2013. The maternal and perinatal outcome were assessed. Most of the women 56 (34.78%) were aged 22 to 25 years and mean age was 24.54 ± 4.18 years. Primi para was noted in 85 (52.80%) of the women and history of previous preterm pregnancy was present in 3.11% of women. Labour was indicated in 60 (37.27%) of the women while in 101 (62.73%) it was spontaneous. In those with indicated labour,...
Risk factor and perinatal outcome of preterm delivery in a tertiary care centre in rural Haryana
International journal of reproduction, contraception, obstetrics and gynecology, 2020
Preterm labour (PTL) is defined as the onset of the labour before the 37th completed weeks of gestation which is calculated from the first day of her last menstrual period or early trimester ultrasonography. It complicates about 10% to 15% of all pregnancies and is the most common cause of perinatal morbidity and mortality. Preterm delivery affects 1 in 10 births (11%) in U.S.A and even greater births in developing countries and causes 40% to 75% neonatal deaths. Over 60% of preterm births occurred in Sub-saharan Africa and South Asia as compared to other parts of the world. India is one of the ten countries with the highest numbers of estimated preterm birth. The causes of pre-term birth could be maternal, fetal, placental and others. Both maternal and fetal factors are more frequently seen in pregnancies occurring after assisted fertility treatments, thus increasing the risk of both spontaneous and provider-initiated preterm births. Nearly three-fourth of perinatal deaths occur in...
ISRN Obstetrics and Gynecology, 2014
Introduction. Preterm birth is the leading cause of newborn deaths and the second leading cause of death in children under five years old. Three-quarters of them could be saved with current, cost-effective interventions. The aim of this study was to identify the risk factors of preterm birth in a secondary care hospital in Southern India. Methods. In the case-control study, records of 153 antenatal women with preterm birth were included as cases. Age matched controls were women who had a live birth after 37 weeks of gestational age. Gestational age at delivery and associated risk factors were analyzed. Results. The preterm birth rate was 5.8%. Common risk factors associated with preterm birth were hypertensive disorders of pregnancy (21.4%), height <1.50 m (16.8%), premature rupture of membranes (17.5%), and fetal distress (14.9%). Mean birth weight for preterm babies was 2452 grams while the birth weight for term babies was 2978 grams. Conclusion. The commonest obstetrical risk ...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: In spite of the manifold advances in obstetric care, preterm births are still a nightmare for the obstetrician, the pregnant women and her family. The present study aims to study the neonatal outcome in preterm births and its association with sociodemographic, medical and obstetric risk factors.Methods: A prospective observational study done in the Department of Obstetrics and Gynecology in a tertiary level hospital in South India for a period of two years.Results: Majority of the preterm births in this study were in 32-34 weeks which accounted for 53.43% of the preterm births. The immediate neonatal mortality in this study is around 18.25%. The partner’s occupation, the booking status of the mother is strongly associated with preterm births. Pregnancies above the third order were also significantly associated with risk of preterm birth. 44.8% of preterm births are idiopathic, 18.64% have hypertension complicating pregnancy, 14.4% were multiple pregnancies. Neonatal mort...
Preterm Delivery Associated Risk Factor And Its Incidence
Aims: To analyse the risk factors and incidence of preterm delivery at Nepalgunj Medical College Teaching Hospital, Kolhapur. Method: A retrospective study was conducted at Nepalgunj Medical College Teaching Hospital, Kohalpur. All consecutive patients were included for the study and data were collected from record book of labour room and discharge book from statistic department. Results: Total no. of deliveries occurred in our hospital was 3956 during study period, overall incidence of preterm delivery was 512 accompolish (12.94%) total no. of delivery.). Incidence of preterm labour was more among primigravida 293(57.02%) as compared to less than 5 th gravida 128 (38.7%) and >5 th gravida 21 (4.1%). Most of the preterm delivery was occurred in nullipara contributes 315(61.5%) followed by multipara 192 (37.5%) and grand multipara 5(1%). 88.86% were idiopathic, 8.39 % IUFD related,7.42% were feto-maternal and multiple pregnancy , 11.52% abortion related. Conclusions: Preterm delivery contributes 12.94% among the hospital deliveries in a teaching hospital. Preterm delivery was more common among primigravida and PIH .
International Journal of Women's Health
Background: Preterm delivery is a major obstetric complication and a leading cause of neonatal mortality and morbidity. It is also associated with significant costs in terms of psychological and financial hardship, to the families. Objective: The primary objective of this study was to determine the risk factors associated with all preterm deliveries in singleton pregnancy in a tertiary care hospital and the secondary objective was to determine the fetal outcomes among women with preterm delivery. Materials and Methods: A case control study was conducted between January 2019 and June 2019 in the Department of Obstetrics and Gynecology of a tertiary care center in Central Kerala, India. Women who delivered before 37 completed weeks of gestation were taken as cases and those who delivered at or after 37 weeks were considered as controls in a 1:1 ratio, approximately. Data regarding 191 cases and 200 controls were taken from delivery room records of the years 2016 to 2018 with the help of a predesigned checklist. Univariate and multivariate analysis were done to determine the magnitude of association between the exposure factors and preterm delivery. Results: The mean age of study participants among the cases was 29.3 ± 5.1 years and controls was 28.1 ± 4.4. Pregnancy induced hypertension (aOR = 14.60; 95% CI 4.8, 44.1; p<0.001), abnormal amniotic fluid volume (aOR = 10.68; 95% CI 3.46, 32.98; p<0.001), premature rupture of membranes (PROM) (aOR = 10.27; 95% CI 4.82, 21.86; p<0.001), previous history of preterm delivery (aOR = 4.12; 95% CI 1.22, 13.85; p<0.002), history of urinary tract infection (UTI) during pregnancy (aOR = 3.67; 95% CI 1.39, 9.68; p<0.002), systemic diseases (aOR = 2.78; 95% CI 1.28, 6.39; p<0.001), anaemia (aOR = 2.54; 95% CI 1.28, 5.03; p<0.004) were found to be the independent risk factors for preterm delivery. On analyzing the fetal outcomes, the average birth weight of preterm babies was 2 ± 0.6 kg compared to 3.1kg among term babies. Conclusion: Early detection and adequate treatment of various conditions like anaemia, pregnancy induced hypertension, UTI and systemic illness can help in reduction of the prevalence of preterm delivery.
A retrospective analytical study of the epidemiology and causes of preterm birth
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
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 recor...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013
Background: Preterm birth is the most significant problem in current obstetric practice and according to the World Health Organization is the direct cause accounting for 24% of neonatal deaths. Prevalence of preterm birth range between 7-16% and are similar worldwide. There is scarcity of data on preterm birth in India despite having highest number of births and neonatal deaths in the world. The available data indicate that 15% of all neonatal deaths are caused by prematurity and its complication. Methods: A cross sectional study was done in order to find out incidence of preterm labour and resultant mortality and morbidity associated with preterm deliveries. Over a period of 3 years from 01.01.2008 to 31.12.2010, 3843 pregnant mothers delivered in rural MIMER Medical College, Pune out of which there were 27 cases of twins (24 preterm twins and 3 term twins) and 2 cases of triplets (preterm). Out of 3874 newborns, 476(12.2%) were preterm after excluding the babies with lethal congenital anomalies. 448 mothers (24 preterm twins and 2 preterm triplets) giving birth to 476 preterm babies excluding the lethal congenital malformations were studied. Results: The overall perinatal mortality amongst preterm births for the 3 years were 426.4/ 1000 preterm birth. Preterm deliveries contributed to 61.50 % of perinatal deaths. Out of 476 preterm babies 83 were stillborn and 120 had early neonatal deaths; thus giving a perinatal mortality rate of 426.4 per thousand preterm births. The main cause of perinatal morbidity was LBW, followed by RDS, septicemia, IUGR and birth asphyxia. The mortality of babies was strongly associated with RDS (18.32%), septicaemia (22.5%), extreme prematurity (14.16%) and birth asphyxia (26%). Conclusion: This manuscript describes the design, methodology used and the three years result of this cross sectional study to analyze and audit the perinatal mortality and morbidity due to preterm deliveries in a tertiary care teaching hospital of rural area of Maharashtra.