Njunwa Mujuni Rutasera, Naburi Helga, Alwy Al-Beity Fadhlun
Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Rwanda J Med Health Sci. 2023 Nov 30;6(3):335-345. doi: 10.4314/rjmhs.v6i3.7. eCollection 2023 Nov.
Preterm birth contributes to significant neonatal and under-five mortality and morbidities. This study assessed the risk factors associated with preterm births at a tertiary teaching hospital in Dar es Salaam, Tanzania.
Case-control study to compare risk factors of preterm birth amongst 140 women with preterm deliveries as cases and 280 women with term deliveries as controls. A structured interviewer-administered questionnaire was used. Univariate and multivariable logistic regression analyses were done using STATA version 17 software.
The proportion of preterm deliveries was 17.9%. Women with less than four antenatal visits were three times more likely to have a preterm birth than those with four or more attendances (aOR 3.6, 95% CI 1.95-6.57, P < 0.001). The odds of preterm birth increased among women who experienced antepartum haemorrhage (aOR 25.7, 95% CI 12.72-52.03, P < 0.001), pre-eclampsia/eclampsia (aOR 29.9, 95% CI 7.78-115.41, P < 0.001) and preterm membrane rupture (aOR 62.8; 95% CI 23.51-168.21, P < 0.001). Among multiparous women, short interpregnancy intervals, prior preterm birth, or stillbirth increased the odds of preterm birth.
Poor antenatal attendance, obstetric complications, and premature rupture of membranes were among the identified risk factors. All could be addressed by quality antenatal care.
早产导致大量新生儿及五岁以下儿童死亡和发病。本研究评估了坦桑尼亚达累斯萨拉姆一家三级教学医院中与早产相关的风险因素。
采用病例对照研究，比较140例早产女性（病例组）和280例足月分娩女性（对照组）的早产风险因素。使用结构化访谈问卷。采用STATA 17版软件进行单因素和多因素逻辑回归分析。
早产比例为17.9%。产前检查次数少于4次的女性早产的可能性是检查次数为4次或更多的女性的三倍（调整后比值比3.6，95%置信区间1.95 - 6.57，P < 0.001）。发生产前出血（调整后比值比25.7，95%置信区间12.72 - 52.03，P < 0.001）、先兆子痫/子痫（调整后比值比29.9，95%置信区间7.78 - 115.41，P < 0.001）和胎膜早破（调整后比值比62.8；95%置信区间23.51 - 168.21，P < 0.001）的女性早产几率增加。在经产妇中，妊娠间隔短、既往早产或死产会增加早产几率。
产前检查不足、产科并发症和胎膜早破是已确定的风险因素。所有这些都可以通过高质量的产前护理来解决。
