Maternal and neonatal profile of late-preterm survivors in a poorly resourced country

Abstract

Objective. To determine maternal indicators and adverse perinatal outcomes among late-preterm infants during birth hospitalization in a low-income country.

Methods. Cross-sectional study of late-preterm and term survivors in a tertiary maternity hospital in southwest Nigeria using multivariable logistic regression analysis and population attributable risk (PAR) percentage. Adjusted odds ratios (OR) and 95% confidence intervals (CI) of significant factors are stated.

Results. Of 4176 infants enrolled, 731 (17.5%) were late preterm and 3445 (82.5%) were full-term. Late-preterm delivery was independently associated with mothers who were unmarried (OR: 1.71, CI: 1.06–2.75), lacked formal education (OR: 1.75, CI: 1.06–2.89), human immunodeficiency virus positive (OR: 1.61, CI: 1.17–2.20), with hypertensive disorders (OR: 3.07, CI: 2.32–4.08), antepartum hemorrhage (OR: 3.66, CI: 1.97–6.84), and were unlikely to have induced labor (OR: 0.010, CI: 0.01–0.69). Hypertensive disorders and antepartum hemorrhage had a combined PAR of 48.4%. Infants born late preterm were more likely to have low 5-min Apgar scores (OR: 1.70, CI: 1.01–2.83), sepsis (OR: 1.62, CI: 1.05–2.50), hyperbilirubinemia (OR: 1.56, CI: 1.05–2.33), admission into special care baby unit (OR: 1.85, CI: 1.38–2.48), and nonexclusive breast-feeding (OR: 1.49, CI: 1.49, CI: 1.18–1.89).

Conclusions. These findings suggest that late-preterm infants in low-resource settings are at risk of severe morbidity and suboptimal feeding. Education and close monitoring of high-risk mothers are warranted to prevent avoidable late-preterm delivery and facilitate the proactive management of unavoidable late-preterm births.

Keywords:

• Exclusive breast-feeding
• HIV
• hypertension in pregnancy
• hyperbilirubinemia
• perinatal care
• Sub-Saharan Africa

Declaration of interest:

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.