Profiling the Socio-Demographic Characteristics and Outcome of Preterm Delivery in Alex Ekwueme Federal University Teaching Hospital Abakaliki

Abstract

Background: Preterm delivery is a major cause of perinatal morbidity and mortality globally. In more than half of the cases, the exact cause is unknown and it is largely unpredictable. Certain maternal, social and demographic characteristics are risk factors and often help to predict and prognosticate the neonatal outcomes. Objective: This study was designed to determine the maternal socio-demographic characteristics and neonatal outcomes of patients managed for singleton preterm delivery in Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Method: This was a 4-year retrospective analysis of patients managed for preterm birth from 1st January 2012 through 31st December 2015. Results: Over the study period there were a total number of 623 singleton preterm deliveries in the facility, while there were 9647 deliveries in the facility; the preterm birth rate was 6.5% or 65 per 1000 deliveries. The mean maternal age was 28.79 ± 5.33 while the mean parity was 1.89 ± 1.98. The mean gestational age and birth weight were 33.67 ± 2.62 and 2.30 ± 0.78 kg respectively. Apgar score in 1 minute was 6.89 ± 3.27, while in the 5th minute was 7.95 ± 3.42. Majority of the patients were multiparous and booked for antenatal care in the facility. Most of the preterm labour started spontaneously and were delivered vaginally. The caesarean section rate in this study was 35.5%. Fetal distress and preeclampsia/eclampsia were the commonest indications for caesarean section. The male to female ratio was 1.1:1. Nearly half of the neonates were born with normal birth weight and 427 (68.5%) were alive at discharge. However, 196 (31.5%) suffered early neonatal death due to prematurity. Maternal parity, booking status and fetal weight were significant determinants of fetal outcome with a p-value < 0.05. Conclusion: Birth weight was the most important determinant of neonatal survival and the unbooked patient was an important determinant of poor outcome. Booking for antenatal care and ensuring optimal weight at delivery would go a long way at reducing the poor neonatal outcome associated with preterm delivery.