Hassan Hiba Bashir, Hassan Yasmin Bashir, Hassan Yahye Sheikh Abdulle, Mohamud Rahma Yusuf Haji, Dirie Abdirahman Mohamed Hassan, Hirsi Ibrahim Mohamed, Barud Asha Abdullahi
Department of Obstetrics and Gynaecology, Mogadishu Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital, Somalia.
Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu, Somalia.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251350529. doi: 10.1177/17455057251350529. Epub 2025 Aug 1.
Preterm birth, delivery before 37 weeks of gestation, affects 15 million births globally and causes 1.1 million under-five deaths annually. In Somalia, decades of civil war have severely weakened the healthcare infrastructure, posing significant challenges to maternal and neonatal healthcare. However, data on preterm birth and its determinants in Somalia remain limited.
This study examines the prevalence and determinants of preterm birth among women delivered at the Mogadishu Somali Turkey Recep Tayyip Erdogan Training and Research Hospital.
Retrospective cross-sectional study.
A retrospective review of 1900 medical records from January to December 2022 was conducted. Data were analyzed using Stata 17, with logistic regression employed to identify significant determinants of preterm birth. The Hosmer-Lemeshow test (p = 0.64) was used to assess model fit, and statistical significance was determined at p < 0.05.
The prevalence of preterm birth was 17.5% (95% confidence interval: 15.8%-19.3%), which aligns with similar studies in Ethiopia (16.1%-16.3%) and Malawi (16.3%), but is lower than in Uganda (24.6%) and Kenya (20.2%). Maternal age below 20 years (adjusted odds ratio = 2.4; 95% confidence interval: 1.34-4.17; p = 0.003), absence of antenatal care visits (adjusted odds ratio = 16.4; 95% confidence interval: 10.96-24.48; p < 0.001), and fewer than four antenatal care visits (adjusted odds ratio = 4.1; 95% confidence interval: 2.66-6.47; p < 0.001) were significant predictors of preterm birth. Obstetric complications such as antepartum haemorrhage (adjusted odds ratio = 12.3; 95% confidence interval: 5.75-26.36; p < 0.001), pregnancy-induced hypertension (adjusted odds ratio = 6.0; 95% confidence interval: 3.77-9.56; p < 0.001), and premature rupture of membranes (adjusted odds ratio = 23.2; 95% confidence interval: 12.60-42.71; p < 0.001) were also significant determinants. Additionally, severe anaemia (adjusted odds ratio = 1.8; 95% confidence interval: 1.06-2.97; p = 0.030) and multiple gestations (adjusted odds ratio = 9.7; 95% confidence interval: 4.27-21.97; p < 0.001) were associated with preterm birth.
The study highlights the high prevalence of preterm birth and identifies significant factors, including inadequate antenatal care visits, pregnancy complications, and multiple gestations. Strengthening antenatal care services, early risk detection, and targeted interventions are critical for reducing preterm birth rates in Somalia.
早产是指妊娠37周前分娩，全球每年有1500万例早产，导致110万5岁以下儿童死亡。在索马里，数十年的内战严重削弱了医疗基础设施，给孕产妇和新生儿保健带来了重大挑战。然而，索马里早产及其决定因素的数据仍然有限。
本研究调查了在摩加迪沙索马里土耳其雷杰普·塔伊普·埃尔多安培训与研究医院分娩的妇女中早产的患病率及其决定因素。
回顾性横断面研究。
对2022年1月至12月的1900份病历进行回顾性分析。使用Stata 17进行数据分析，采用逻辑回归确定早产的重要决定因素。采用Hosmer-Lemeshow检验（p = 0.64）评估模型拟合度，p < 0.05为具有统计学意义。
早产患病率为17.5%（95%置信区间：分别为15.8%-19.3%），这与埃塞俄比亚（16.1%-16.3%）和马拉维（16.3%）的类似研究结果一致，但低于乌干达（24.6%）和肯尼亚（20.2%）。母亲年龄低于20岁（调整后的优势比=2.4；95%置信区间：1.34-4.17；p = 0.00）、未进行产前检查（调整后的优势比=16.4；95%置信区间：10.96-24.48；p < 0.001）以及产前检查次数少于4次（调整后的优势比=4.1；95%置信区间：2.66-6.47；p < 0.001）是早产的重要预测因素。产科并发症如产前出血（调整后的优势比=12.3；95%置信区间：5.75-26.36；p < 0.001）、妊娠高血压（调整后的优势比=6.0；95%置信区间：3.77-9.56；p < 0.001）和胎膜早破（调整后的优势比=23.2；95%置信区间：12.60-42.71；p < 0.001）也是重要的决定因素。此外，重度贫血（调整后的优势比=1.8；95%置信区间：1.06-2.97；p = 0.030）和多胎妊娠（调整后的优势比=9.7；95%置信区间：4.27-21.97；p < 0.001）与早产有关。
该研究突出了早产的高患病率，并确定了重要因素，包括产前检查不足、妊娠并发症和多胎妊娠。加强产前保健服务及早期风险检测和针对性干预对于降低索马里的早产率至关重要。
