(P18-024-23) Determinants of Preterm Birth in Kembata Tembaro Zone Public Hospitals, Southern Ethiopia

Objectives: The objective of the study was to identify key determinants of preterm birth in Kembata Tembaro, Southern Ethiopia.

Methods: Institutional unmatched case-control study design was conducted among 310 mothers who gave full-term births (>=37 weeks and less than 43 weeks of gestation) as control and 104 mothers with preterm births ( < 37weeks of gestation) as cases from October 1, 2018, to February 1, 2019. Gestational age of the neonates was determined by reviewing medical records for the last normal menstrual period, fundal height and ultra-sound. Consecutive sampling method was used to select the participants. Bivariate and multivariate logistic regressions were conducted to determine factors associated with preterm birth at p-value < 0.05 using SPSS version 20.0 software.

Results: A total of 104 cases and 310 controls were included in the study. Mothers living in rural villages had a higher probability of having PTB (AOR =2.7; CI: 1.3-5.6). Mothers with no education had a higher chance of getting PTB (AOR= 2.6; CI: 1.3-5.2). Mothers with < 4 antenatal care visits had a higher probability of having PTB (AOR =5.5; CI: 2.1-14.3). Substance abuse increased the risk of PTB (AOR =3.5; CI: 1.1-10.5). In addition, MUAC < 23cm (AOR= 7.2; CI: 3.3-15.7) and pregnancy-induced hypertension (AOR =8.9; CI: 1.2- 69) were also identified as significant determinants of preterm birth.

Conclusions: Despite the relative improvement in the health care delivery system and the increased trend of institutional delivery, the burden of PTB remains a major public health problem in southern Ethiopia. PTB was associated with a number of socio-economic, maternal, healthcare service, and obstetrical factors. Therefore, different prenatal and new-born care intervention strategies should consider the factors associated with PTB to improve pregnancy outcomes and thereby reduce preterm-related morbidity and mortality. Further study is recommended regarding the effect of maternal nutrition on PTB using a longitudinal study design.

Funding Sources: Hawassa University