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The Study of Risk Factors and Perinatal outcome in Preterm Birth

Sowmya S., Assistant Professor, Department of Obstetrics & Gynaecology, Basaveshwara Medical College, Chitradurga, Karnataka 577502, India. , Sowmya S.1 , Bhavana S.2 , Ambarisha Bhandiwad3

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Indian Journal of Obstetrics and Gynecology 6(5):p 514-518, Sep-Oct 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6518.12

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Abstract

Prevalence of preterm birth is 5- 10% of all the pregnancies. Preterm labour is a significant obstetric problem, has a major impact on neonatal mortality and morbidity. It turns a pregnancy into high risk situation which can be detrimental for both mother and the baby. Hence the current study intends to identify the risk factors and the outcome of preterm birth. Objective: 1. To identify the risk factors associated with preterm deliveries. 2. To assess the neonatal morbidity and mortality associated with preterm birth. Materials and Methods: A descriptive study was  undertaken at JSS Hospital, Mysore for one year. The data was collected from the subjects satisfying the inclusion criteria. Data regarding general information, associated risk factors, delivery outcome of antenatal women and also morbidities & mortality of all preterm babies were collected. Results: A total of 1748 deliveries in our hospital 148 were preterm deliveries. Incidence of preterm deliveries is 8.5%. The factors significantly associated are preeclampsia (odds ratio [OR] 5.25) uterine anomalies (OR 5.50), cervical incompetence (OR 4.97), preterm premature rupture of membranes (OR 3.73), antepartum haemorrhage (OR 3.54), multiple gestation (3.12), multigravida (OR 1.67), low socioeconomic status (OR 1.73), education status upto high school (OR 0.34). Perinata  morbidity noted is 69% with 80% babies seeking NICU Care. Significantly associated morbidities seen in preterm babies are hyperbilirubinemia (OR 8.14), septicaemia (OR 6.19), respiratory distress syndrome (OR 4.49), intra uterine fetal demise (OR 5.06), intra uterine growth restriction (OR 2.06). It is mostly seen in babies of gestational age 31-34 weeks (35.14%). Perinatal mortality is 11.4%. Discussion & Conclusion: Early identification of risk factors, diagnosis of preterm labour, use of prophylactic pharmacologic therapy to prolong gestation like tocolytic therapy when indicated, and systematic maternal and fetal surveillance and patient education will go a long way in improving outcome of preterm infants.

Keywords: Preterm Birth; NICU; Low Birth Weight; Tocolytic Therapy.

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6518.12

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