Assessment of risk factors associated with pre-term labour in Tertiary care Hospitals, Lahore

2021 ◽  
Vol 15 (1) ◽  
pp. 13-17
Author(s):  
Tanzeela Zafar ◽  
Iram Manzoor ◽  
Fariha Farooq

Background: Pakistan has one of the highest rates of preterm births, nearly 16 for every 100 babies born. Around 4% of these premature babies, are at highest likelihood of death. The objective of this study was to assess association of multiple risk factors with preterm birth in Pakistani women. Patients and methods:  An analytical cross-sectional study was carried out in Obstetrics and Gynecology Department of Akhtar Saeed Trust Hospital and Farooq Hospital, West Wood Branch, Lahore from October 2018 to December 2019. Total 116 pregnant females who gave birth to preterm babies with gestational age between 20-37 weeks were included. Data about patients’ socio-demographic profile, previous obstetric history and current gestational profile was collected using closed ended structured questionnaire. Variables were presented in the form of frequency tables. Chi-square and Fisher exact test were applied to establish association of various risk factors and preterm presentation of patients’ in hospital. A p-value ≤ 0.05 was taken as significant. Results: Out of 116 participants, 49 (42.2%) were aged between 20-25 years, 47 (40.5%) were illiterate. Of the total sample 60 (51.7 %) participants were obese (BMI >30). Eighty-two (70.7%) patients were multigravida and 65 (56.1%) gave the history of previous cesarean section. Significant association was found between preterm birth and multi-parity (p=0.001), previous history of abortion (p=0.000), intrauterine death (p=0.001), infertility (p=0.04), cesarean-section (p=0.000), and inter-pregnancy interval of less than 24 months (p=0.007). Other significant factors associated with preterm labour were urinary tract infections (p=0.001), documented fever more than 101oF (p=0.000), anemia (p=0.000), singleton pregnancy (p=0.000) and cephalic fetal presentation (p=0.002), during current pregnancy. Conclusion: Multi-gravidity, history of abortion, intrauterine death, previous infertility, cesarean-section, inter-pregnancy interval of less than 24 months, UTI, genital tract infection, anemia, singleton pregnancy and cephalic fetal presentation during current pregnancy were observed to be significantly associated with preterm births.

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e045399
Author(s):  
Agustín Díaz-Rodríguez ◽  
Leandro Feliz-Matos ◽  
Carlos Bienvenido Ruiz Matuk

ObjectivesThis study aimed to identify the risk factors associated with preterm birth, and to determine the prevalence of preterm births in the Dominican Republic.DesignCase-control study.SettingsSeven National Reference Hospitals from different regions of the Dominican Republic.ParticipantsA probabilistic sampling of both cases and controls was performed with a ratio of 2.92:1, and a power analysis was performed with α=0.05, P1=0.5, P2=0.6, and β=0.08, to yield a distribution of 394 cases and 1150 controls. Estimation of gestational age was based on neonatologist reports.Primary outcome measuresA protocol was created to obtain maternal and obstetric information.ResultsThe main risk factors were a family history of premature births (p<0.001, OR: 14.95, 95% CI 8.50 to 26.29), previous preterm birth (p=0.005, OR: 20.00; 95% CI 12.13 to 32.96), advanced maternal age (over 35 years; p<0.001, OR: 2.21; 95% CI 1.57 to 3.09), smoking (p<0.001, OR: 6.65, 95% CI 3.13 to 13.46), drug consumption (p=0.004, OR: 2.43, 95% CI 1.37 to 4.30), premature rupture of membranes (p<0.001, OR: 2.5) and reduced attendance at prenatal consultations (95% CI 6 to 7, Z=−10.294, p<0.001).ConclusionMaternal age greater than 35 years, previous preterm birth, family history of preterm births and prelabour rupture of membranes were independent risk factors for preterm birth. Adolescence, pregnancy weight gain and prenatal consultations, on the other hand, were protective factors for preterm birth. Although the prevalence of premature births in this study was 25%, this could have been biased.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S345-S345
Author(s):  
Dheeraj Goyal ◽  
Kristin Dascomb ◽  
Peter S Jones ◽  
Bert K Lopansri

Abstract Background Community-acquired extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae infections pose unique treatment challenges. Identifying risk factors associated with ESBL Enterobacteriaceae infections outside of prior colonization is important for empiric management in an era of antimicrobial stewardship. Methods We randomly selected 251 adult inpatients admitted to an Intermountain healthcare facility in Utah with an ESBL Enterobacteriaceae urinary tract infection (UTI) between January 1, 2001 and January 1, 2016. 1:1 matched controls had UTI at admission with Enterobacteriaceae but did not produce ESBL. UTI at admission was defined as urine culture positive for &gt; 100,000 colony forming units per milliliter (cfu/mL) of Enterobacteriaceae and positive symptoms within 7 days prior or 2 days after admission. Repeated UTI was defined as more than 3 episodes of UTI within 12 months preceding index hospitalization. Cases with prior history of ESBL Enterobacteriaceae UTIs or another hospitalization three months preceding the index admission were excluded. Univariate and multiple logistic regression techniques were used to identify the risk factors associated with first episode of ESBL Enterobacteriaceae UTI at the time of hospitalization. Results In univariate analysis, history of repeated UTIs, neurogenic bladder, presence of a urinary catheter at time of admission, and prior exposure to outpatient antibiotics within past one month were found to be significantly associated with ESBL Enterobacteriaceae UTIs. When controlling for age differences, severity of illness and co-morbid conditions, history of repeated UTIs (adjusted odds ratio (AOR) 6.76, 95% confidence interval (CI) 3.60–13.41), presence of a urinary catheter at admission (AOR 2.75, 95% CI 1.25 – 6.24) and prior antibiotic exposure (AOR: 8.50, 95% CI: 3.09 – 30.13) remained significantly associated with development of new ESBL Enterobacteriaceae UTIs. Conclusion Patients in the community with urinary catheters, history of recurrent UTIs, or recent antimicrobial use can develop de novo ESBL Enterobacteriaceae UTIs. Disclosures All authors: No reported disclosures.


2014 ◽  
Vol 40 (6) ◽  
pp. 617-625 ◽  
Author(s):  
Hamilton Rosendo Fogaça ◽  
Fernando Augusto de Lima Marson ◽  
Adyléia Aparecida Dalbo Contrera Toro ◽  
Dirceu Solé ◽  
José Dirceu Ribeiro

OBJECTIVE: To determine, in a sample of infants, the prevalence of and risk factors for occasional wheezing (OW) and recurrent wheezing-wheezy baby syndrome (WBS). METHODS: Parents of infants (12-15 months of age) completed the International Study of Wheezing in Infants questionnaire. RESULTS: We included 1,269 infants residing in the city of Blumenau, Brazil. Of those, 715 (56.34%) had a history of wheezing, which was more common among boys. The prevalences of OW and WBS were 27.03% (n = 343) and 29.31% (n = 372), respectively. On average, the first wheezing episode occurred at 5.55 ± 2.87 months of age. Among the 715 infants with a history of wheezing, the first episode occurred within the first six months of life in 479 (66.99%), and 372 (52.03%) had had three or more episodes. Factors associated with wheezing in general were pneumonia; oral corticosteroid use; a cold; attending daycare; having a parent with asthma or allergies; mother working outside the home; male gender; no breastfeeding; and mold. Factors associated with WBS were a cold; physician-diagnosed asthma; ER visits; corticosteroid use; pneumonia; bronchitis; dyspnea; attending daycare; bronchodilator use; having a parent with asthma; no breastfeeding; mother working outside the home; and a dog in the household. CONCLUSIONS: The prevalence of wheezing in the studied population was high (56.34%). The etiology was multifactorial, and the risk factors were intrinsic and extrinsic (respiratory tract infections, allergies, attending daycare, and early wheezing). The high prevalence and the intrinsic risk factors indicate the need and the opportunity for epidemiological and genetic studies in this population. In addition, mothers should be encouraged to prolong breastfeeding and to keep infants under six months of age out of daycare.


2020 ◽  
Vol 32 (2) ◽  
pp. 90-93
Author(s):  
Mst Afroza Khanum ◽  
Salma Lavereen ◽  
Moniruzzaman ◽  
Romana

Background: Currently preterm labour is one of the most challenging problems confronting the obstetricians and perinatologists. This unfortunate episode accounts for 50-75% of the perinatal mortality. Methods: A cross sectional study was conducted on 210 pregnant women with preterm labour admitted in Monno Medical College Hospital, Manikganj from June 2014 to December 2015, to study the causes and outcome of preterm birth in Tertiary health centre of Manikganj. Results: Occurence of preterm birth was 13.82%; 47.14% occured between 34-37 weeks of gestation; 33.80% occured 31-33 weeks of gestation and occurred in 28-30 weeks 19.04%. About 22% patients presenting with preterm labour had a past history of abortions and 14.3% had a history of preterm delivery. Premature rupture of membranes was found to be the most common risk factor related with preterm labour in the present pregnancy. Genitourinary tract infection was the next important risk factor of preterm labour; 24.8% (86) patients had either vaginal infection (19.5%) or urinary infection (21.4%) or both. Another important risk factor identified in this study was antepartum haemorrage which was cause in 11.4 % cases. Preterm babies commonly suffered from various complications like jaundice (32.1%), respiratory distress syndrome (22.6%), asphyxia (13.5%), sepsis, hypoglycemia and coagulopathy. Conclusion: Most of the preterm births occured between 34-37 weeks of gestation. Most common risk factors of preterm births are history of abortion and preterm delivery in previous pregnancy; PROM UTI vaginal infection, PIH and APH in correct pregnancy. Newborn jaundice, RDS and birth asphyxia are the common neonatal morbidity in preterm labour. Identifying risk factors to prevent the onset of preterm labour and advanced neonatal care unit can help decrease neonatal morbidity and mortality. Bangladesh J Obstet Gynaecol, 2017; Vol. 32(2) : 90-93


2020 ◽  
Vol 7 (5) ◽  
pp. 1130
Author(s):  
Gobinaath . ◽  
Arun Daniel J.

Background: Febrile seizures occur commonly in the under 5 age group and is associated with few risk factors causing its recurrence like very high fever, family history of seizures, low sodium levels and younger age of onset which are subject to seasonal and wide geographical variations. This study aimed at detecting the major risk factors associated with recurrent febrile seizures in an Indian population.Methods: A retrospective hospital-based study was conducted among a total of 300 cases aged 6 months to 5 years attending to the paediatric OPD with history of fever followed by febrile seizures. Information regarding socio-demographic and clinical variables associated with febrile seizure was collected and analyzed.Results: The mean age of the study participants was 25.6±2.2 months and majority (60%) were males. Family history of seizures was present in 25.3% (n=76) of the children with febrile seizures. Respiratory infections (73.3%) and gastroenteritis (17%) were the major infective reasons associated with the occurrence of febrile seizures followed by pneumonia (6.3%) and urinary tract infections (5%). Recurrence of FS was significantly higher among the children with family history of FS (p=0.009), age at onset lesser (p<0.001) and simple FS seizures.Conclusions: Younger age at onset and positive family history of seizures were important socio-demographic risk factors associated with recurrent febrile seizures.


2017 ◽  
Vol 5 (7) ◽  
pp. 1016-1020 ◽  
Author(s):  
Badriah Ali Alansi ◽  
Hytham Bahaeldin Mukhtar ◽  
Maher Ahmad Alazizi ◽  
Amjad Ahmad Zuiran ◽  
Areej Mohammed AL-Atawi ◽  
...  

AIM: To investigate risk factors for early preterm birth.METHODS AND MATERIAL: A retrospective comparative study was conducted at Tabuk, Kingdom of Saudi Arabia during the period from January to December 2010. Five hundred and ninety-five patient's files and delivery registry logbooks were reviewed, the following information was collected; demographic data, current and past obstetric histories. Then the early and late preterm births were compared for various risk factors. The Statistical Package for Social Sciences (SPSS version 22) was used. The Chi-square and t-test were used to test the statistical significance and a P-value<0.05 considered significant.RESULTS: Prevalence of early preterm birth was found to be 2.5% in our study group. Women at risk for early preterm birth were: primigravidas (33.7% vs. 26.2% for control), P-value 0.039, OR 1.429 and 95% CI 0.982 - 2.079); multiple gestations (87.7% vs. 95.1% for control, P-value 0.002, OR 0.368 and 95% CI 0.196 - 0.688); and patients with a prior history of placental abruption (3.7% vs. 1.0% for control, P-value 0.027, OR3.928 and 95% CI 1.1360 - 13.586).CONCLUSIONS: Current study indicated that early preterm births differed from preterm as a whole; primigravida, multiple gestations and a history of placental abruption are independent risk factors for them.


Author(s):  
Shaveta Garg ◽  
Tajinder Kaur ◽  
Ajayveer Singh Saran ◽  
Monu Yadav

Background: Preterm births are still the leading cause of perinatal mortality and morbidity. It is a major challenge in the obstetrical health care.Methods: This study was conducted over a period of eight months from September 2016 till April 2017 at a tertiary care hospital. All patients who delivered a live baby before 37 weeks of gestation were included in the study.Results: Present study was conducted on 100 eligible women out of which 7 delivered before 30 weeks but majority of them (55%) delivered after 34 weeks of gestation. In our study, most of the patients (66%) presented in active phase of labor which resulted in preterm birth of baby. The most common risk factor of preterm labor was genitourinary tract infections (34%) followed by Preterm Premature rupture of membranes (22%). Past obstetric history of preterm delivery and abortions also had a significant impact on the present pregnancy outcome.Conclusions: Preterm labour and birth still have a high incidence causing significant neonatal mortality and morbidity as well as economic burden on family and hospital. The causes of preterm birth are multifactorial and modifiable. This incidence can be reduced by early identification of established risk factors, as revisited and reemphasized in our study, with the help of universal and proper antenatal care.


Author(s):  
Shehla Jamal ◽  
Ruchi Srivastava

Background: Preterm birth is the leading cause of perinatal morbidity and mortality. The incidence of preterm birth in India is 7-9%, and the rates are constantly rising. The main cited reasons for this trend are increasing indicated preterm births and rising rates of artificially conceived pregnancies. Major causes for indicated preterm births are hypertensive disorders of pregnancy, foetal growth restriction, antepartum haemorrhage and PPROM. Risk factors for spontaneous preterm birth include obstetrical complications like multifetal gestation, malpresentations and infections, poor antenatal care, having history of previous preterm delivery, and history of bleeding in the index pregnancy.Methods: This is a retrospective analytical study, done in the department of Obstetrics and Gynecology over a period of two years (January 2015-December 2016). All singleton preterm live births were included in the study. The records of all the included patients were studied from the medical records department of the hospital, after obtaining permission for the same. The results were analysed and obtained by percentage method.Results: A total of 2564 pregnancies were analysed in present study. The number of preterm deliveries was 436 in two years. Out of 2564, the number of live births was 2365, making an incidence of 18.4%. Maximum preterm deliveries were observed in the teenage group (27%) and elderly gravidas (23.9%), both the groups falling into high risk categories for preterm birth. Multiparity was an independent risk factor observed in our study and was found to be associated with 47.5% cases. Level of antenatal care received was also directly related to the number of preterm deliveries. As high as 58.4% of the females landed into preterm birth, who never sought antenatal care, the commonest risk factor for preterm birth was PPROM (26.6%) followed by hypertensive disorders of pregnancy (18.6%). We observed a labor induction rate of 23.4% and Caesarean delivery was performed in 146 (33.5%) cases, thus indicating a high induction and caesarean rates in such pregnancies.Conclusions: Preterm birth continues to challenge obstetricians despite much efforts being executed at all levels. Many of the risk factors are identifiable and can be addressed with a specialised antenatal care program. Screening of genitourinary infections and initiation of treatment can cut down the rates. Early referral and NICU equipped institutional delivery should be promoted to prevent neonatal morbidity and mortality.


Author(s):  
Sapna D. Berry ◽  
Rajeev Sood ◽  
Kalpna Negi ◽  
Naveen Kumar

Background: Preterm labour and preterm deliveries are very challenging obstetric complications. Early identification of risk factors may help identify women at risk for preterm deliveries.Methods: A one-year observational study was conducted in the department of obstetrics and gynecology, IGMC Shimla, Himachal Pradesh from 1st August 2017 to 31st July 2018. All mothers who delivered between 24 to 37 weeks were subjected to a detailed history with respect to age, parity, previous pregnancy outcomes and to identify the presence of any risk factors. A thorough obstetric and systemic examination was done. Parametric and non-parametric test of significance were used to find the association between different quantitative and qualitative variable.Results: Incidence of preterm deliveries was 11.4%. Maximum cases were of age group 25-30 years. 71.7% belonged to lower socio-economic status. 54% cases were seen in multigravida. History of previous abortion was seen in 18.4% and 9.7% had history of preterm deliveries. 12% cases had history of 1st trimester bleeding.  Spontaneous onset of preterm labour was seen in 55.1%. The significant risk factors associated were PIH and genitourinary infections.Conclusions: The risk factors of preterm birth to a large extent can be identified in antenatal period. Adolescent health education including good nutrition, good hygiene, counselling for contraception to reduce unintended pregnancies and birth spacing can lower the preterm birth rate. Better prenatal care, early identification of risk factors and complicated cases, regular follow up and proper management can help us in reducing preterm births.


2021 ◽  
Vol 23 (2) ◽  
pp. 179-184
Author(s):  
Upanish Oli ◽  
Radhika Upreti ◽  
Neebha Ojha ◽  
Meeta Singh

Preterm birth (PTB) is one of the major causes of morbidity in newborn. The aim of this study was to estimate the prevalence and to compare the associated risk factors of early and late PTB. This was a hospital-based cross sectional study conducted in 2016/2017. Women, 271, having PTB at 28-33+6 weeks period of gestation was taken as early PTB and 34-36+6 were taken as late PTB. Data was collected using semi-structured questionnaire, patients’ record book, adopting face- to - face interview technique and clinical examination. The annual prevalence of PTB was 7.25% of which 11% were <28+0 weeks, early PTB was 32% and late PTB was 57%. Mother with school education were 2.0 times more likely to have early preterm births than those having higher education (P-value: 0.005, COR: 2.061,95% CI:1.234-3.441). Mothers with positive history of PTB in any of previous pregnancy was 10.7 times more likely to have early PTB in current pregnancy (P-value: <0.001, COR: 10.677, 95% CI: 2.792 – 40.746). Both variables were found to have independent risk on early PTB in logistic regression analysis (education: P-value: 0.027, aOR: 2.973, 95% CI: 1.132- 3.047; previous history of PTB: P-value: 0.002, aOR: 9.191, 95% CI: 2.308 - 36.596). Early and late PTB have differential risk factors. Mothers with positive history of PTB and having lower level of education were more likely to have early PTB.


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