Maternal, reproductive and obstetric factors associated with preterm births in Mulago Hospital, Kampala, Uganda: a case control study

INTRODUCTION: Preterm birth, a leading cause of neonatal mortality accounts for 35 percent of all neonatal deaths worldwide. Uganda's high preterm birth rate of 13.6 per 1000 live births ranks 28th in the world. Efforts at reducing these pre-term births must entail interventions that target any associated risk factors. This study therefore aimed at identifying and describing the risk factors for preterm births among mothers delivering in Mulago Hospital. METHODS: This was a case control study among postpartum women in Mulago Hospital. Ninety nine women with preterm newborns were recruited as cases and 193 with full term babies were the controls. A semi-structured questionnaire was used to collect data. Data was entered into Epidata version 3.1 and exported to STATA 11 for univariate analysis and multivariate analysis by logistic regression. RESULTS: Risk factors for preterm birth included maternal height less than 1.5 meters (OR 131.08 (20.35-844.02)), rural residence (OR 6.56(2.68-16.10)) and failure to attend antenatal care clinic (OR 8.88(1.44-54.67)). Pregnancy related risk factors included PPROM (OR 287.11(49.26-1673.28)), antepartum haemorrhage (OR 7.33(1.23-43.72)) and preeclampsia/eclampsia (OR 16.24(3.11-84.70)). CONCLUSION: Preterm birth is more likely to occur in women of short stature, living in rural areas and those who do not attend antenatal care clinic. The preterm birth risk is higher for women who get PPROM, APH and preeclampsia/eclampsia in pregnancy. Early recognition and management of these high risk conditions among pregnant women may lead to a reduction in preterm birth rates.