Damanhuri, Narisa Hatun Ahmad
(2018)
Characteristics and associated factors of preterm birth at Hospital Universiti Sains Malaysia (HUSM) in 2016.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background: Worldwide, preterm birth remains a significant public health threat in
view of its increasing trend and devastating health effects. Similarly, in Malaysia the
proportions of preterm birth and related neonatal death were observed to be rising
since 2011. However to date, there are limited publications on local preterm birth
specifically on its characteristics and associated factors.
Objectives: The study aimed to investigate on preterm birth in terms of its
characteristics and associated factors at HUSM in 2016.
Methodology: Retrospective record review on secondary data was conducted by
means of a cross-sectional study design in Part I (n=4,246) and a case-control study
design in Part II (n=472). Data on mothers attending HUSM for deliveries in 2016
were extracted from the iMOMz database. Descriptive analysis was used in Part I to
determine the proportions of preterm births and the proportions of preterm births
based on its characteristics (sub-categories, types and neonatal outcomes). Univariate
and multivariate analyses were used in Part II to identify the associated factors of
preterm birth.
Results: The proportion of preterm birth among live births at HUSM in 2016 was
6.5%. All of the preterm births (n=278) fell under the sub-category of moderate to
late preterm and predominantly were spontaneous type (74.5%). Only 1.8% of the
neonates of these preterm births died within the first 28 days of their lives. The
presence of hypertension was significantly associated with preterm birth. Motherswith hypertension had 2.46 higher odds to experience preterm birth compared to
mothers with no hypertension when adjusted for mothers with red-tagging (OR=2.46,
95% CI: (1.06, 5.72), p=0.037). Additionally, the presence of red-tagging was also
significantly associated with preterm birth. Mothers with red-tagging had 2.06 higher
odds to experience preterm birth compared to mothers with no red-tagging when
adjusted for mother with hypertension (OR=2.06, 95% CI: (1.37, 3.10), p=0.001).
Conclusion:
There were significant associations between hypertension and red-tagging with
preterm birth. Thus, optimising blood pressure control prior to and during pregnancy
as well as preventing the occurrence of pre-eclampsia and its progression to
eclampsia are essentially some of the recommended measures, which may improve
pregnancy outcomes and reduce the preterm birth rate. In this study however, the
model of fitness suggests that it has limited use for prediction. Therefore, future
studies need to include all other risk factor variables which were not studied as these
variables may improve the internal validity and outcome of studies on predictive risk
factors of preterm birth.
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