Agarwal Ritika, Agrawal Rajni
Obstetrics and Gynaecology, Venkateshwara Institute of Medical Science, Gajraula, IND.
Cureus. 2024 Feb 5;16(2):e53673. doi: 10.7759/cureus.53673. eCollection 2024 Feb.
Background Preterm birth before 37 weeks of gestation is a global public health challenge, particularly in India, where the prevalence varies regionally. Understanding risk factors, such as maternal age and complications like hypertensive disorders, is vital. India's diverse healthcare landscape and regional disparities further complicate this issue. Preterm infants face increased mortality and morbidity risks like respiratory distress and intraventricular hemorrhage. This study in a tertiary care hospital aimed to analyze risk factors, assess perinatal outcomes, and contribute to the understanding of preterm birth in this complex context, providing valuable insights for maternal and child health strategies. Methods This retrospective cohort study was conducted at the Venkateshwara Institute of Medical Science, Rajabpur, over one year, extracting data from electronic health records. The study aimed to analyze risk factors associated with preterm delivery and assess perinatal outcomes. The study included diverse pregnancies, both singleton and multiple gestations, and employed sample size calculations to ensure statistical validity. Trained medical personnel collected extensive data on maternal characteristics, obstetric history, antenatal care, perinatal outcomes, and mode of delivery. Statistical analysis, utilizing SPSS (IBM, Chicago, USA), involved descriptive statistics, comparative analysis, chi-square tests, t-tests, Mann-Whitney U tests, and multivariate logistic regression models. Findings with a p-value <0.05 were considered significant. Results The study included 2042 deliveries, with a preterm birth prevalence of 14.2%. Multiparous women had higher preterm birth rates than primigravida (72.92% vs. 27.08%). Maternal age, history of preterm delivery, hypertensive disorders, inadequate antenatal care compliance, previous cesarean section, multiple gestations, antepartum hemorrhage (APH), polyhydramnios, oligohydramnios, and premature rupture of membranes (PROM) were significantly associated with preterm birth. Apgar scores at one minute and five minutes, neonatal complications, and mortality rates were notably worse among preterm births. Vaginal delivery rates were significantly lower in the preterm group (36.3%) compared to full-term deliveries (48.8%), with a higher rate of emergency cesarean sections (19.7% vs. 10.8%). Conclusion This study provides valuable insights into the risk factors and perinatal outcomes of preterm delivery at a tertiary care hospital, with precise values illustrating the extent of associations. The findings such as history of preterm delivery, hypertensive disorders, and inadequate antenatal care compliance as the most commonly associated conditions with preterm birth and management of such associated conditions may help reduce the rate of premature birth.
妊娠37周前的早产是一项全球公共卫生挑战，在印度尤其如此，该国早产患病率存在地区差异。了解诸如产妇年龄和高血压疾病等并发症等风险因素至关重要。印度多样化的医疗保健格局和地区差异使这一问题更加复杂。早产婴儿面临呼吸窘迫和脑室内出血等更高的死亡率和发病率风险。这项在一家三级护理医院开展的研究旨在分析风险因素、评估围产期结局，并有助于在这一复杂背景下理解早产问题，为母婴健康策略提供有价值的见解。
这项回顾性队列研究在拉贾布尔的文卡特斯瓦拉医学科学研究所进行，为期一年，从电子健康记录中提取数据。该研究旨在分析与早产相关的风险因素并评估围产期结局。该研究纳入了各种妊娠情况，包括单胎和多胎妊娠，并采用样本量计算以确保统计有效性。训练有素的医务人员收集了关于产妇特征、产科病史、产前护理、围产期结局和分娩方式的广泛数据。利用SPSS（美国伊利诺伊州芝加哥市IBM公司）进行统计分析，包括描述性统计、比较分析、卡方检验、t检验、曼-惠特尼U检验和多变量逻辑回归模型。p值<0.05的结果被认为具有统计学意义。
该研究包括2042例分娩，早产患病率为14.2%。经产妇的早产率高于初产妇（72.92%对27.08%）。产妇年龄、早产史、高血压疾病、产前护理依从性不足、既往剖宫产史、多胎妊娠、产前出血（APH）、羊水过多、羊水过少和胎膜早破（PROM）与早产显著相关。早产婴儿出生后1分钟和5分钟的阿氏评分、新生儿并发症和死亡率明显更差。早产组的阴道分娩率（36.3%）明显低于足月分娩组（48.8%），急诊剖宫产率更高（19.7%对10.8%）。
这项研究为一家三级护理医院早产的风险因素和围产期结局提供了有价值的见解，精确的数据说明了关联程度。诸如早产史、高血压疾病和产前护理依从性不足等最常与早产相关的情况以及对此类相关情况的管理，可能有助于降低早产率。
