Preterm Incidence with Analytical Assessment of Causes and Risk Factors of Mortality

Abstract

BACKGROUND AND OBJECTIVE: Prematurity is a serious health problem and an important risk factor in neonatal mortality. This study aimed to determine the incidence rate of preterm newborns in the neonatal care unit and to study their different causes and risk factors in relation to their outcomes. METHODS: We conducted a prospective cross-sectional study in Misan Hospital for Child and Maternity during the whole year of 2018. All preterm neonates with gestational age 26-37 weeks needed ventilation support and associated with risk factors were enrolled in this study. Different preterm variables were studied in relation to their outcome including gestational age, birth weight, length, head circumference, gender, type of pregnancy, mode of delivery, presence of congenital anomaly, ventilation support. While maternal variables include age, address, antenatal care, education, past maternal history, and maternal risk factor such as antepartum hemorrhage, premature rupture of membrane, hypertension, diabetes mellitus, previous cesarean section, and previous premature labor. FINDINGS: There was a predominance of males with mean gestational age and birth weight of (32.6±3.1) weeks and (1755.25±485.8) grams, respectively. Prematurity and its complications were responsible for more than one-third of neonatal hospitalization and their mortality rate was 36.1%. We found a converse significant correlation between the gestational age, as well as, anthropometric parameters of preterm infants and their outcomes (p<0.05). Preterm mortality was more significant in those who delivered vaginally or needed ventilation support. High maternal educational level, urban setting and more antenatal visits were associated with less neonatal death. While antepartum hemorrhage, abortion, and premature rupture of membrane were associated with poor outcome. CONCLUSION: A high rate of preterm admission was observed in the neonatal care unit of Misan hospital with subsequent poor outcome. Determining their risk factors can be used to improve the outcome.