Prevalence and risk factors associated with preterm birth at Nyamata district hospital: July-August 2019

Abstract

Background: Preterm birth, defined as childbirth occurring at less than 37 completed weeks or 259 days of gestation from the first day of the last menstrual period, is the major determinant of neonatal mortality and morbidity worldwide and remains a public health concern. Of the estimated 3 million neonatal deaths occurring globally each year, about 1 million are directly related to prematurity. No studies have been carried out locally to determine the prevalence of as well as factors associated with preterm delivery in Rwanda. This study aimed to determine the prevalence and risk factors associated with preterm birth among women admitted in the delivery service at Nyamata District Hospital located in Bugesera District in Rwanda.

Methods: This was a health facility-based cross-sectional study that used data that were collected in July-August 2019 through structured interviews and medical records. A total of 400 women were enrolled into the study at Nyamata District Hospital. Study participants’ sociodemographic, psychological and medical characteristics are described using frequencies and prevalence. Bivariable and multivariable logistic regression models were performed to determine factors associated with pre-term birth using SPSS version 21.

Results: The prevalence of preterm birth in Nyamata Hospital was found to be at 9%. Most of respondents 78.8 % were aged between 20 to 35 years. Almost a quarter of respondents had a Body Mass index between below 18.5 and a quarter had Mid-Upper Arm Circumference below 24cm. Weight gain during pregnancy (OR: 3.89, CI: 1.10–13.77), MUAC below 24cm (OR: 5.85, 1.26-27.24), interpregnancy interval (OR: 7.60, CI: 1.10–52.43), and stress ( high level) during pregnancy (OR: 7.68, CI:1.37–42.92) , were independently risk factors of preterm birth in Nyamata district hospital. Health insurance (OR: 0.27; CI: 0.08-0.83) have an independent protective effect. Moreover, marital status, level of education, smoking during pregnancy, alcohol use during pregnancy, multiple pregnancy, attending antenatal visit and pregnancy induced hypertension were not found to be risk factors of preterm birth.

Conclusion: The prevalence of preterm birth in Nyamata Hospital find to be high compare to Rwanda ambition o reaching SDGs. Different risk factors like, interpregnancy interval, stress during pregnancy and MUAC below 24cm were associated with preterm birth. All women at risk should receive special care during pregnancy and designed interventions such as dedicated preterm birth prevention clinics, preconception care package and antenatal care package including nutrition are suggested in order to prevent preterm birth.