Prevalence and Risk Factors Associated with Preterm Birth at Irene-Neto Lubango Provincial Maternity- Huila /Angola

Abstract

According to WHO (2018), almost 15 million babies are born every year before 37 weeks of pregnancy, the majority taking place in Sub Saharan Africa and in south Asia. Preterm birth is a common complication of pregnancy and usually bore heavy short- and long-term medical, socio-economic and financial burden to the affected children, the family, the heath system and the community as all. Angola with one of the highest fertility rates in the world, 6.2 according to the DHS 2015-2016, coupled with the fact that preterm birth is regarded as a traumatic social even for the parent and a quite expensive condition to the health system will need to stablish the main risk factors for preterm birth in order to inform strategies to prevent its occurrence. We conducted an hospital based cross sectional study to determine the prevalence and the risk factors of preterm birth at Irene Neto Maternity Hospital- Lubango-Angola. Three trained research assistants were recruited from the post labour wards and the new born unit and trained to collect data. Gestational age was calculated using a standard obstetric wheel based on menstrual dates or first trimester ultrasound (when available).  A Newborn clinical assessment using the Finnstrom Score aided by a printed pictorial scoring chart was then conducted within 24 hours of birth, by a trained medical Doctor for confirmation. 17.7% of women giving birth at Lubango maternity hospital had a preterm new-born. Among the socio- demographics factors, only maternal age (p :0.021), family income(p:0.032), use of alcohol (p: 0.013) and lack ANC (p: <0.001) were associated with premature birth. Clinical factors found to increase the risk of premature birth included Antecedent of hypertension (p: 0.021), Preeclampsia (p: 0.026), Malaria (p:0.001) and multiple gestation (p: 0.01). Only antecedent of premature birth (p:0.0049), lack of antenatal care (p<0.001), malaria (p:0.009) and multiple gestation (p: 0.001) remained significant after controlling for confounders. Premature birth is still a public health problem in Angola, principally among pregnant women who do not attend ANC clinic and those with multiple gestation. Malaria infection during pregnancy as well as preeclampsia are also serious predictors of premature birth. With a prevalence of 17.7%, premature birth is a still a serious problem at lubangopediatric hospital and deserve a multisectoral well-coordinated action. ANC clinic should be actively promoted, improved and expended. Pregnant women with antecedent of premature birth should be closely monitored Preeclampsia and malaria should be prevented, searched and serious treated when present during pregnancy. We the recommend a Multicentre and large sample size, longitudinal observational analytic study for better understanding of the principal predictors at a country level.