Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi 6205, Bangladesh.
Department of Orthopaedic Surgery, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia.
BMJ Open. 2022 Oct 10;12(10):e061920. doi: 10.1136/bmjopen-2022-061920.
Preterm delivery (PD) is a worldwide health burden particularly in low-income and middle-income countries such as Bangladesh. It is a key indicator of neonatal mortality and a risk of morbidity in later life. This study aimed to determine the prevalence of PD and its associated factors among mothers in Northern region of Bangladesh.
Multistage sampling technique was used to select samples covering all the population from 9 Upazilas in Rajshahi district with 233 community clinics. A total of 540 mothers and their under-5 children were enrolled for the study. Descriptive statistics, χ test and logistic regression model were used to analyse the data.
Among all live births, the prevalence of PD was found to be 14.6%. Multiple binary logistic regression model suggested five factors of PD: (1) mothers who used contraceptive pill had lower chance of PD (p<0.05); (2) mothers with high fever during pregnancy period were more likely to have PD (p<0.05); (3) mothers who did not receive antenatal care service less than four times during pregnancy period had higher chance of PD (p<0.01); (4) mothers first married before 18 years who were more likely to have PD (p<0.01); (5) PD delivered mothers had more chance to get low birth weight children (p<0.05). In addition, unadjusted model demonstrated that mothers delivered first baby before their age<20 years were more risk to get PD (p<0.05).
Approximately one in seven infants was born preterm in our study area. Family planning method, number of antenatal care visit, mothers' age at marriage and high fever during pregnancy were the most important predictors of PD, these factors could be considered to reduce PD among Bangladeshi mothers. PD risk could be reduced by counselling and encouraging women to take antenatal care facilities from trained health providers.
早产（PD）是一个全球性的健康负担，尤其是在孟加拉国等低收入和中等收入国家。它是新生儿死亡率的一个关键指标，也是以后生活中发病的一个风险因素。本研究旨在确定孟加拉国北部地区母亲中 PD 的流行情况及其相关因素。
采用多阶段抽样技术，从拉杰沙希区的 9 个乌帕齐拉中选取覆盖所有人群的样本，共有 233 个社区诊所。共有 540 名母亲及其 5 岁以下儿童被纳入研究。采用描述性统计、卡方检验和逻辑回归模型分析数据。
在所有活产儿中，PD 的患病率为 14.6%。多变量二项逻辑回归模型表明 PD 的五个因素：（1）使用避孕药的母亲发生 PD 的几率较低（p<0.05）；（2）怀孕期间有高热的母亲更有可能发生 PD（p<0.05）；（3）怀孕期间产前护理服务次数少于 4 次的母亲发生 PD 的几率较高（p<0.01）；（4）18 岁前首次结婚的母亲更有可能发生 PD（p<0.01）；（5）PD 分娩的母亲更有可能生下低体重儿（p<0.05）。此外，未调整模型表明，母亲在<20 岁时分娩第一胎的风险更高（p<0.05）。
在我们的研究地区，大约每七个婴儿中就有一个是早产儿。计划生育方法、产前护理次数、母亲结婚年龄和怀孕期间高热是 PD 的最重要预测因素，这些因素可被用于降低孟加拉国母亲的 PD 风险。通过咨询和鼓励妇女接受经过培训的卫生提供者提供的产前保健设施，可以降低 PD 风险。
