Abstract

Purpose: To identify risk factors for spontaneous preterm delivery (SPD) given that it is associated with high neonatal morbidity and mortality. Material and methods: This case-control study was carried out between 1st February and 31st July 2021. Women who delivered spontaneously between 28 and ˂37 weeks (cases) or at ≥37 weeks (controls) were recruited. The main variables recorded included maternal age and parity, inter-pregnancy interval, if the pregnancy was intended, medical, obstetrical and family past-histories, gestational age at delivery, number of gestation and pathologies during current gestation. Fisher exact test, t-test and logistic regression were used for comparison. P<0.05 was considered statistically significant. Results: Our frequency of preterm delivery was 15.3% (116/759 births), with 9.9% (75/759) being SPD. Significant risk factors for SPD were premature rupture of membranes (aOR 19.96, 95%CI 11.04-45.82), inter-pregnancy interval ˃60 months (aOR 13.02, 95%CI 6.11-33.01), Nulliparity (aOR 10.21, 95%CI 5.72-21.31), 1st degree family history of SPD (aOR 7.73, 95%CI 1.54-11.39), malaria in the 3rd trimester (aOR 6.89, 95%CI 2.15-8.63), multiple pregnancies (aOR 6.43, 95%CI 3.21-9.79), severe anemia (Hb ˂6g/dl) in the 3rd trimester (aOR 5.73, 95%CI 2.04-10.60) and unintended pregnancies (aOR 2.44, 95%CI 1.98-7.88). Conclusion: Women with multiple or unintended pregnancies and those with the pregestational risk factors identified above should be well followed up during pregnancy to allow prevention, if not, early diagnosis of SPD. Moreover, prevention of the aboveidentified pathologies in pregnancy is mandatory if we want to reverse the rate of SPD.

Keywords

spontaneous preterm delivery, risk factors, premature rupture of membranes, nulliparity, multiple pregnancies