چکیده (انگلیسی):

Objective: Preterm delivery is the second most leading cause of under-five deaths in the
world and has been associated with poor neonatal outcomes especially in developing
countries where management of severe and extreme preterm new-born is a challenge.
This study aimed to determine maternal and obstetric factors associated with preterm
delivery among women who delivered at Kilimanjaro Christian Medical Centre.
Methods: This was unmatched case-control study conducted at the Kilimanjaro Christian
Medical Centre between April and May, 2014. A total of 1143 women were recorded
to have delivered during the study period. Of these, 162 had preterm delivery which
comprised the case group while controls were selected from women who had term birth
(n = 209) making a final sample size of 371 women. All participants were interviewed
using a standard questionnaire to determine factors associated with preterm delivery.
Additional data were extracted from maternal clinic cards and hospital records. Data
analysis was performed using statistical package for social science version 20.0. Odds
ratios with 95% CI for factors associated with preterm delivery were estimated in a
multivariate logistic regression models. A P-value of <0.05 was considered statistically
significant.
Results: The prevalence of preterm birth was 14.2%. Numerous factors were associated
with preterm delivery including living alone (AOR 5.26, 95% CI: 1.11–25.14), no formal
education (AOR 1.2, 95% CI: 3.55–4.06), heavy physical works during pregnancy (AOR
3.13, 95% CI: 1.44–6.81), being a peasant (AOR 2.24, 95% CI: 1.16–4.33), business
women (OR 2.88, 95% CI: 1.44–5.74), and history of still birth (OR 4.93; 95% CI: 1.59–
15.35). Furthermore, history of miscarriage (OR 1.84, 95% CI: 1.02–3.31), preeclampsia
(OR 6.83, 95% CI: 2.92–15.96), placenta previa (OR 7.54, 95% CI: 1.65–34.51),
abruption placenta (OR 4.04, 95% CI: 1.08–15.17), Caesarean section delivery (OR 1.60,
95% CI: 1.06–2.43), inadequate ANC visits <4 (OR 3.25, 95% CI: 2.04–5.19), multiple
pregnancy (OR 2.75, 95% CI: 1.15–6.61), low birth weight (OR 34.27, 95% CI: 15.93–
73.7) and UTIs during pregnancy (OR 1.678, 95% CI: 1.064–2.649) were also independently
associated with preterm delivery.
Conclusion: The risk factors for preterm delivery identified in this study are consistent
with previous studies. Clinicians and other health care providers should routinely assess
women at high risk of preterm delivery during prenatal care to prevent the occurrence of
preterm delivery and associated adverse perinatal outcomes.