Prevalence and Determinants of Pre-term Deliveries in the University of Ilorin Teaching Hospital, Ilorin, Nigeria

Abstract

In Nigeria, over 900,000 children under the age of five years die every year. Early neonatal death is responsible for a little over 20% of these deaths. Prematurity remains a significant cause of these early neonatal deaths. In some series, it is reported to be responsible for 60-70% of these deaths. This study aimed to determine the prevalence and determinants of pre-term deliveries at the University of Ilorin Teaching Hospital, Ilorin. This was a prospective cohort study conducted over a 9-month period at the University of Ilorin Teaching Hospital. Records of deliveries and data on maternal socio-biological and antenatal variables were collected during this period in order to determine the prevalence and determinants of pre-term deliveries. Out of the 2,489 deliveries that took place over a 9-month period, there were 293 pre-terms, giving a pre-term delivery rate of 120 per 1,000 deliveries. Of the total deliveries, 1,522 singleton deliveries that satisfied inclusion criteria were recruited; 185 of them were pre-term deliveries giving a case:control ratio of 1:7. Significant determinants of pre-term delivery identified were previous pre-term delivery (P=0.001; OR=3.55; 95% CI=1.71-7.30), antepartum hemorrhage (P=0.000; OR=8.95; 95%CI=4.06-19.78), premature rupture of the membranes (P=0.000; OR=6.48; 95%CI=4.33-9.67), maternal urinary tract infection (P=0.006; OR=5.89; 95%CI=1.16-27.57), pregnancy induced hypertension (P=0.007; OR=3.23; 95%CI=2.09-4.99), type of labor (P=0.000; OR=6.44; 95%CI=4.42-9.38) and booking status (P=0.000; OR=4.67; 95%CI=3.33-6.56). The prevalence of pre-term delivery was 120 per 1,000 live births. Factors significantly associated with pre-term delivery were low socio-economic class, previous pre-term delivery, antepartum hemorrhage, premature rupture of fetal membranes, urinary tract infection, pregnancy induced hypertension, induced labor, and booking elsewhere outside the teaching hospital.