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Risk Factors Associated with Preterm Delivery in Singleton Pregnancy in a Tertiary Care Hospital in South India: A Case Control Study

Authors Sureshbabu RP, Aramthottil P, Anil N, Sumathy S, Varughese SA, Sreedevi A, Sukumaran SV

Received 21 December 2020

Accepted for publication 9 March 2021

Published 9 April 2021 Volume 2021:13 Pages 369—377


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Everett Magann

Raveena Pallithazath Sureshbabu,1 Parvathi Aramthottil,1 Neelanjana Anil,1 Sudha Sumathy,2 Steffi Ann Varughese,1 Aswathy Sreedevi,1 Sheejamol Velickakathu Sukumaran3

1Department of Community Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India; 2Department of Obstetrics and Gynaecology, Amrita Institute of Medical Science, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India; 3Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, 682041, Kerala, India

Correspondence: Aswathy Sreedevi
Department of Community Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
Tel +91-9447294260
Email [email protected]

Background: Preterm delivery is a major obstetric complication and a leading cause of neonatal mortality and morbidity. It is also associated with significant costs in terms of psychological and financial hardship, to the families.
Objective: The primary objective of this study was to determine the risk factors associated with all preterm deliveries in singleton pregnancy in a tertiary care hospital and the secondary objective was to determine the fetal outcomes among women with preterm delivery.
Materials and Methods: A case control study was conducted between January 2019 and June 2019 in the Department of Obstetrics and Gynecology of a tertiary care center in Central Kerala, India. Women who delivered before 37 completed weeks of gestation were taken as cases and those who delivered at or after 37 weeks were considered as controls in a 1:1 ratio, approximately. Data regarding 191 cases and 200 controls were taken from delivery room records of the years 2016 to 2018 with the help of a predesigned checklist. Univariate and multivariate analysis were done to determine the magnitude of association between the exposure factors and preterm delivery.
Results: The mean age of study participants among the cases was 29.3 ± 5.1 years and controls was 28.1 ± 4.4. Pregnancy induced hypertension (aOR = 14.60; 95% CI 4.8, 44.1; p< 0.001), abnormal amniotic fluid volume (aOR = 10.68; 95% CI 3.46, 32.98; p< 0.001), premature rupture of membranes (PROM) (aOR = 10.27; 95% CI 4.82, 21.86; p< 0.001), previous history of preterm delivery (aOR = 4.12; 95% CI 1.22, 13.85; p< 0.002), history of urinary tract infection (UTI) during pregnancy (aOR = 3.67; 95% CI 1.39, 9.68; p< 0.002), systemic diseases (aOR = 2.78; 95% CI 1.28, 6.39; p< 0.001), anaemia (aOR = 2.54; 95% CI 1.28, 5.03; p< 0.004) were found to be the independent risk factors for preterm delivery. On analyzing the fetal outcomes, the average birth weight of preterm babies was 2 ± 0.6 kg compared to 3.1kg among term babies.
Conclusion: Early detection and adequate treatment of various conditions like anaemia, pregnancy induced hypertension, UTI and systemic illness can help in reduction of the prevalence of preterm delivery.

Keywords: preterm birth, risk factors, case control study, singleton pregnancy

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