Department of Obstetrics and Gynecology. Jigme Dorji Wangchuck National Referral Hospital, Thimphu.
Faculty of Postgraduate medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu.
J Nepal Health Res Counc. 2024 Mar 22;21(3):505-513. doi: 10.33314/jnhrc.v21i3.4933.
Preterm birth is the child birth before 37 completed weeks .Prematurity is one of the leading causes of neonatal morbidity and mortality due to the complications associated with it. The objective of the study was to determine the maternal risk factors associated with all preterm birth in singleton pregnancy at National hospital.
Hospital based unmatched case control study was conducted between March 2021 to December 2021 at National hospital, Thimphu, Bhutan. Case to control ratio was 1:2.Data were collected using interviewer -administered structured questionnaires. The collected data were entered into Epi-data and exported into SPSS for analysis. Independent variables with p-valves<0.05 in the univariate analysis were entered to multi variable logistic model to estimate the strength of association .P-valve <0.05 was considered significant.
Total of 107 cases and 201 controls participated with a response rate of 95.95%.Multiple logistic regression showed that mothers with ANC follow ≤ four[aOR 9.58(7.36-28.86) ], previous history of preterm delivery [aOR 2.99(1.5-15.77) ], previous caesarean section [aOR 5.72(2.19-14.92)], prelabour rupture of membrane [aOR 8.67(3.78-19.73)], fetal growth restriction [aOR 7.28(2.11-25.11)] , and pre-eclampsia [aOR 10.99(6.75-85.29) were the risk factors positively associated with preterm birth .
This study highlights that preeclampsia, number of antenatal care visits ≤ four, prelabour rupture of membrane, fetal growth restriction, previous caesarean section and previous preterm delivery were the risk factors for preterm birth. This show the need of early screening and prevention of preeclampsia, strengthening of antenatal care follow-up, and treatment of infection to prevent prelabour rupture of membrane, reducing primary caesarean section and more attention and care with previous preterm birth .
早产是指在 37 周完成前分娩。由于与早产相关的并发症，早产是新生儿发病率和死亡率的主要原因之一。本研究的目的是确定与在 National 医院单胎妊娠中所有早产相关的产妇危险因素。
这是一项 2021 年 3 月至 2021 年 12 月在不丹廷布的 National 医院进行的基于医院的病例对照研究。病例对照比为 1:2。使用访谈员管理的结构化问卷收集数据。收集的数据录入 Epi-data 并导出到 SPSS 进行分析。单变量分析中 p 值<0.05 的自变量被纳入多变量逻辑回归模型以估计关联强度。p 值<0.05 被认为具有统计学意义。
共有 107 例病例和 201 例对照参与，应答率为 95.95%。多变量逻辑回归显示，产前检查次数≤4 次的母亲[aOR 9.58(7.36-28.86)]、有早产史的母亲[aOR 2.99(1.5-15.77)]、有剖宫产史的母亲[aOR 5.72(2.19-14.92)]、胎膜早破的母亲[aOR 8.67(3.78-19.73)]、胎儿生长受限的母亲[aOR 7.28(2.11-25.11)]和子痫前期的母亲[aOR 10.99(6.75-85.29)]是与早产相关的正相关危险因素。
本研究强调，子痫前期、产前检查次数≤4 次、胎膜早破、胎儿生长受限、剖宫产史和早产史是早产的危险因素。这表明需要早期筛查和预防子痫前期，加强产前保健随访，治疗感染以预防胎膜早破，减少初次剖宫产，并对既往早产给予更多关注和护理。
