Determinants of preterm birth at Jimma University Medical Center, southwest Ethiopia

Abstract

Background

Preterm birth is the second leading cause of death next to pneumonia in children aged <5 years and the single-most important cause of death in the first month of life. Research examining determinants of preterm birth in Ethiopia is limited. Therefore, this study aimed to determine risk factors associated with preterm births at Jimma University Medical Center in southwest Ethiopia.

Methods

This unmatched case–control study was conducted from March 15 to April 1, 2017 from medical records of mothers and newborns delivered at Jimma University Medical Center from January 1 to December 30, 2016. Data were extracted using a structured checklist for cases (preterm) and controls (term) by reviewing maternal and newborn medical records using a simple random-sampling technique. Risk factors for preterm delivery were determined using bivariate and multivariate logistic regression models. Statistically significant associations were declared at P<0.05.

Results

The present study evaluated 218 maternal and newborn cases and 438 controls. Risk factors identified were history of previous preterm birth (AOR 6.4, 95% CI 2.9–13.9), preeclampsia (AOR 6.6, 95% CI 3.3–13.4), premature membrane rupture (AOR 11.7, 95% CI 6.2–21.9), antenatal care of fewer than four visits (AOR 4.8, 95% CI 1.2–19), birth interval <2 years (AOR 2.7, 95% CI 1.7–4.5), and multiple pregnancies (AOR 4.5, 95% CI 2.4–8.5).

Conclusion

History of previous preterm births, preeclampsia, premature membrane rapture, antenatal care of fewer than four visits, birth interval <2 years, and multiple pregnancies were found to have a possible causal relationship with preterm births. Therefore, similar further studies should be conducted to generate more population-based evidence on determinants of preterm births.

Keywords:

• determinants
• preterm birth
• pregnant women
• gestational age
• newborn

Acknowledgments

This study was funded by Jimma University postgraduate office. The authors are thankful to the Faculty of Public Health, Jimma University, for financial and technical support. They are also grateful to the JUMC staff and administrators for their support in the whole process of the study. Finally, they thank the research assistants who contributed to data collection.

Author contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.