Determinants of Preterm Birth at the Postnatal Ward of Kenyatta National Hospital, Nairobi, Kenya ()
ABSTRACT
Background: Preterm birth, delivery
prior to 37 completed weeks or 259 days gestation, is a worldwide maternal and
perinatal challenge and is a leading cause of neonatal morbidity and mortality. Preterm birth remains the leading cause of perinatal
and postnatal mortality and morbidity especially in developing countries where
the health care services are suffering from limited
resources. Premature babies usually suffer from both immediate and long term consequences. Right
after birth, they have difficulties in breathing, temperature regulation,
bleeding, infection and other problems due to organ immaturity. Their growth
and developmental milestones will also be affected leading poor physical, mental, educational and psychosocial problems as a long
term consequences. Preterm deliveries were responsible for 1 million out of the 6.3 million
deaths of children under5 in2013 REF _Ref493689700 \r \h \* MERGEFORMAT [1]. In Kenyatta National hospital, few studies have been carried out to
determine the prevalence and factors associated with preterm birth. Hence the aim
of this study is to determine the prevalence and factors associated with
preterm birth at Kenyatta national hospital (KNH), Nairobi, Kenya. Materials
and Methods: This
was a hospital based descriptive cross-sectional study involving randomly selected respondents
(N = 183) from post natal ward of
Kenyatta National Hospital. Systematic random sampling method was applied to recruit the study
respondents. A pre-tested semi-structured questionnaire was
employed to collect information on the possible determinants of Preterm birth.
Data was analysed usingSPSSsoftware version 22.0. Descriptive analysis was done using mean and frequency
proportion. Inferential analysis using chi-square test was used to establish
association different variables. The ethical approval to conduct the study was
obtained from KNH-University of Nairobi Ethical Review Committee (KNH-UoN ERC).
Permission to collect data was sought from the KNH and consent was obtained
from the selected respondents before administering the questionnaire. Result: The prevalence rate of preterm birth was 20.2%.
History of urinary tract infection during pregnancy [AOR =
4.62; 95% CI = 1.56 - 4.67; P = 0.013], history of preterm birth [AOR =
5.8; 95% CI = 1.18 - 10.30; P = 0.001], history of abortion [AOR = 3.54; 95%
CI = 1.18 - 10.41; P = 0.016], history of hypertension during pregnancy [AOR =
2.04; 95% CI = 1.14 - 3.64; P = 0.012], maternal age (≥31 years) [AOR = 2.81;
95% CI = 1.24 - 5.87; P = 0.012] and alcohol consumption during pregnancy [AOR
= 2.56; 95% CI = 0.68 - 9.64; P = 0.014] were determined as significant risk factors
for preterm birth. Conclusion and recommendation: The determinants of preterm birth are multifactorial
including history of abortion, preterm birth, urinary tract infection,
hypertension and alcohol consumption during pregnancy. Most of these risk
factors of preterm birth are controllable if reproductive age mothers are
educated properly. It is very important for antenatal mothers to adhere to the
guidelines of antenatal visits so that those at risk are spotted and close
monitoring can done in order to reduce this high rate of preterm birth and its
negative consequences. Strategies to avert the high prevalence of preterm birth
and its associated morbidity and mortality must be given priority at national,
regional and international levels, so that the Millennium Development Goal (MDG) 4 can be achieved.