A prospective study on neonatal outcome of preterm births and associated factors in a South Indian tertiary hospital setting

Authors

  • Tinu Philip Department of Obstetrics and Gynecology, Believers Church Medical College Hospital, Tiruvalla, Kerala, India
  • Pramod Thomas Department of Community Medicine, Believers Church Medical College Hospital, Tiruvalla, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20184923

Keywords:

Fetal anomalies, Hypertension, Neonatal outcome, Preterm birth, Spontaneous preterm birth

Abstract

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 mortality was 30.8 % in pregnancies with hypertension complicating pregnancies. Most common complication of prematurity in present study was Hyaline Membrane Disease and pneumonia.

Conclusions: Preventive measures, early identification of risk factors and strengthening the referral system will improve the outcome of the preterm babies and to ensure a positive pregnancy outcome to all pregnant women.

References

National health portal of India: May 23,2016 Available at http://ww.nhp.gov.in

Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388(10063):3027-35

Hack M, Fanaroff AA. Outcomes of extremely immature infants – a perinatal medicine. N Engl JMed. 1993;329:1649-1650.

Shrestha S, Dangol SS, Shrestha M, Shrestha RP. Outcome of preterm babies and associated risk factors in a hospital. J Nepal Med Asso. 2010;50(180).

Iams JD, Romero R, Culhane JF, Goldenberg RL. Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. Lancet. 2008;371(9607):164-75.

National Institute of Health and Care Excellence Guidelines: November 2015: Available at https://www.nice.org.uk

WHO antenatal care randomised trial: manual for the implementation of the new model.Geneva:World Health Organisation :2002

Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes: Behrman RE, Butler AS, editors. Preterm Birth: Causes, Consequences, and Prevention. Washington (DC): National Academies Press (US); 2007. Summary. Available at: https://www.ncbi.nlm.nih.gov/books/NBK11350/.

Fuchs F, Monet B, Ducruet T, Chaillet N, Audibert F. Effect of maternal age on the risk of preterm birth: A large cohort study. Gutman J, ed. PLoS ONE. 2018;13(1):e0191002.

Halimi Asl AA, Safari S, Parvareshi HM. Epidemiology and Related Risk Factors of Preterm Labor as an obstetrics emergency. Emerg (Tehran). 2017;5(1):e3.

Heaman M, Kingston D, Chalmers B, Sauve R, Lee L, Young D. Risk Factors for Preterm Birth and Small‐for‐gestational‐age Births among Canadian Women. Paediat Perinat Epidemiol. 2013;27(1):54-61

Shetty MB, Krupa BM, Malyala M, Swarup A, Pathadan DS, Pocha S. Preterm birth: associated risk factors and outcome in tertiary care center. Int J Reproduct, Contracep, Obstet Gynecol. 2017;6(8):3271-4.

Prakash SA, Rasquinha S, Rajaratnam A. Analysis of Risk Factors and Outcome of Preterm Labor. Int J Eng Sci. 2016;2602

Shreshta S, Dangol SS, Shreshta M, Shreshta RPB. Outcome of preterm babies and associated risk factors in a hospital. J Nepal Med Assoc. 2010;50(180):286-90.

Taskeen R. Preterm delivery. A major predictor of perinatal morbidity and mortality. JPMI. 2006;20(3):279-83.

Pandey K, Bhagoliwal A, Gupta N, Katiyar G. Predictive value of various risk factors for preterm labour. J Obstet Gynaecol India. 2010;60(2):141-5.

Carr-Hill RA, Hall MH.The repetition of spontaneous preterm labour. Br J Obstet Gynecol. 1985;92(9):921-8.

Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bulletin of the World Health Organization. 2010;88(1):31-8.

Fernandes SF, Chandra S. A study of risk factors for preterm labour. Int J Reprod Contracept Obstet Gynecol 2015;4(5):1306-12

Kase JS,Visintainer P. The relationship between congenital malformations and preterm birth. J Perinat Med. 2007;35(6):538-42.

Victoria B, Michelle M, Kristin G, Teresa S, Gonzalez VJ, Mary N. The Risk of Preterm Birth in Pregnancies with Fetal Anomalies. Obstet Gynecol. 2017;129(5):176S

Meis PJ, Goldenberg RL, Mercer B, Moawad A, Das A, McNellis D, et al. The preterm prediction study: significance of vaginal infections. Am J Obstetrics Gynaecol. 1995;173(4):1231-5.

Svenvik M, Brudin L, Blomberg M. Preterm birth: a prominent risk factor for low Apgar scores. BioMed research international. 2015;2015.

Lee HC, Subeh M, Gould JB. Low Apgar score and mortality in extremely preterm neonates born in the United States. Acta Paediatrica. 2010;99(12):1785-9.

Manikyamba D, Madhavi N, Prasad AK, Padmavati IV A. Morbidity and mortality of LBW Babies and their growth and neurodevelopment outcome at 1 year–NICU, Government General Hospital, Kakinada. Scholars J Appl Med Sci. 2015;3(4B):1721-5.

Cupen K, Barran A, Singh V, Dialsingh I. Risk factors associated with preterm neonatal mortality: A case study using data from Mt. Hope Women’s Hospital in Trinidad and Tobago. Children. 2017;4(12):108.

Downloads

Published

2018-11-26

Issue

Section

Original Research Articles