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Objectives: To identify incidence and risk factors of preterm delivery among women who delivered in Northeastern Thailand.
Materials and Methods: A descriptive study was conducted at Srinagarind Hospital, the tertiary care hospital in the Northeastern Thailand. Medical records of 1,108 women who had delivery from January 2017 to December 2018 were reviewed. The incidence rate of preterm birth and the risk factors were identified and preterm birth was classified into spontaneous preterm and indicated preterm cases in subgroup analysis. To analyze the data, Chi-square test and multiple logistic regression models were used to identified odds ratios(OR) with 95% CI and P-value of <0.05 was considered statistically significant.
Results: The incidence of preterm birth was estimated as 10.83 %. The spontaneous preterm birth was the largest category, at 67 % of preterm birth. The risk factors were associated with preterm birth included the number of time to antenatal care < 4, multifetal pregnancy, placenta previa and hypertensive disorders in both univariate and multivariate analyses. After subgroup analysis, inter-pregnancy interval between 6-12 months, multifetal pregnancy and fetal growth restriction were statistically significantly associated with spontaneous preterm birth group even after adjusting for confounding factors. The maternal cardiac disease was associated with increased risk of all preterm subtypes.
Conclusion: Inadequate antenatal care (ANC), multifetal pregnancy, placenta previa and hypertensive disorders were strongly associated risk factor for preterm delivery in Northeastern Thailand. Additionally, subgroup analysis showed inter-pregnancy interval between 6-12 months, multifetal pregnancy and fetal growth restriction were statistically significantly associated with spontaneous preterm birth. The Northeastern Thailand pregnancy women should be routinely screened for these risk factors and prevented to decrease preterm birth.
2. Lawn JE, Wilczynska-Ketende K, Cousens SN. Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epidemiol. 2006; 35:706–18.
3. Barker DJ, Osmond C, Simmonds SJ, Wield GA. The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life. BMJ. 1993 Feb 13;306(6875):422–6.
4. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller A-B, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. The Lancet. 2012 Jun;379(9832):2162–72.
5. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. The Lancet. 2008;371:75–84
6. Ferrero DM, Larson J, Jacobsson B, Di Renzo GC, Norman JE, Martin JN, et al. Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births. PLOS ONE. 2016 Sep 13;11(9):e0162506.
7. Ruiz M, Goldblatt P, Morrison J, Kukla L, Švancara J, Riitta-Järvelin M, et al. Mother’s education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts. J Epidemiol Community Health. 2015 Sep;69(9):826–33.
8. Qin J-B, Sheng X-Q, Wu D, Gao S-Y, You Y-P, Yang T-B, et al. Worldwide prevalence of adverse pregnancy outcomes among singleton pregnancies after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis. Arch Gynecol Obstet. 2017 Feb;295(2):285–301.
9. Faber T, Kumar A, Mackenbach JP, Millett C, Basu S, Sheikh A, et al. Effect of tobacco control policies on perinatal and child health: a systematic review and meta-analysis. Lancet Public Health. 2017 Sep;2(9):e420–37.
10. Many A, Hill LM, Lazebnik N, Martin JG. The association between polyhydramnios and preterm delivery. Obstet Gynecol 1995;86(3):389-391.
11. Chen Y-H, Lin H-C, Chen S-F, Lin H-C. Increased risk of preterm births among women with uterine leiomyoma: a nationwide population-based study. Hum Reprod. 2009 Dec 1;24(12):3049–56.
12. Tehranian N, Ranjbar M, Shobeiri F. The Prevalence Rate and Risk Factors for Preterm Delivery in Tehran, Iran. JMRH. 2016;4(2):600-604.
13. Fuchs F, Monet B, Ducruet T, Chaillet N, Audibert F. Effect of maternal age on the risk of preterm birth: A large cohort study. PLOS ONE. 2018 Jan 31;13(1):e0191002.
14. Temu TB, Masenga G, Obure J, Mosha D, Mahande MJ. Maternal and obstetric risk factors associated with preterm delivery at a referral hospital in northern-eastern Tanzania. Asian Pac J Reprod. 2016 Sep;5(5):365–70.
15. Han Z, Lutsiv O, Mulla S, McDonald SD. Maternal Height and the Risk of Preterm Birth and Low Birth Weight: A Systematic Review and Meta-Analyses. J Obstet Gynaecol Can. 2012 Aug;34(8):721–46.
16. Ip M, Peyman E, Lohsoonthorn V, Williams MA. A case-control study of preterm delivery risk factors according to clinical subtypes and severity. J Obstet Gynaecol Res. 2010 Feb;36(1):34–44.
17. Atjimakul T, Liabsuetrakul T. Risk Factors for Two Consecutive Preterm Births in Southern Thailand.Thai J Obstet Gynaecol. 2010;18(3):98-105.
18. Zhang Q, Ananth CV, Li Z, Smulian JC. Maternal anaemia and preterm birth: a prospective cohort study. Int J Epidemiol. 2009 Oct 1;38(5):1380–9.
19. Leal M do C, Esteves-Pereira AP, Nakamura-Pereira M, Torres JA, Theme-Filha M, Domingues RMSM, et al. Prevalence and risk factors related to preterm birth in Brazil. Reprod Health. 2016 Oct;13(S3):127.
20. Di Renzo GC, Giardina I, Rosati A, Clerici G, Torricelli M, Petraglia F. Maternal risk factors for preterm birth: a country-based population analysis. Eur J Obstet Gynecol Reprod Biol. 2011 Dec;159(2):342–6.
21. Wendt A, Gibbs CM, Peters S, Hogue CJ. Impact of Increasing Inter-pregnancy Interval on Maternal and Infant Health: Inter-Pregnancy Interval Impact on Maternal and Infant Health. Paediatr Perinat Epidemiol. 2012 Jul;26:239–58.
22. Arroll B, Goodyear-Smith F, Crengle S, Gunn J, Kerse N, Fishman T, et al. Validation of PHQ-2 and PHQ-9 to Screen for Major Depression in the Primary Care Population. Ann Fam Med. 2010 Jul 1;8(4):348–53.
23.Nguyen N, Savitz DA, Thorp JM. Risk factors for preterm birth in Vietnam. Int J Gynaecol Obstet. 2004; 86: 70–78.
24. Kim YJ, Lee BE, Park HS, Kang JG, Kim JO, Ha EH. Risk Factors for Preterm Birth in Korea. Gynecol Obstet Invest. 2005;60(4):206–12.
25. Deressa AT, Cherie A, Belihu TM, Tasisa GG. Factors associated with spontaneous preterm birth in Addis Ababa public hospitals, Ethiopia: cross sectional study. BMC. 2018;18:332-338.
26. Carlini L, Somigliana E, Rossi G, Veglia F, Busacca M, et al. Risk factors for Spontaneous Preterm Birth: A Northern Italian Multicenter Case-Control Study. Gynecol Obstet Invest. 2002;53:174-180.