Abstract
BackgroundPre-term and post-term births are major determinants of neonatal mortality, including short- and long-term morbidity. In developing countries, where pre-term and post-term births are disproportionately common, the magnitude and underlying causes are not well understood, and evidence is required to design appropriate interventions. This study measured the incidence and identified risk factors of pre-term birth and post-term births in Ethiopia. In addition, it examined the effects of pre-term and post-term birth on neonatal mortality.MethodThis study is a portion of prospective cohort study conducted on 1152 live births born between April and July 2014 in seven hospitals in Tigray region, Northern Ethiopia. Neonatal mortality and birth outcomes were considered as dependent variables. Data were collected using a structured questionnaire and weekly neonatal follow up directed at midwives. Data were described using frequency, percentage, ratio of relative risk (RRR), and 95 % confidence interval (CI). We used multinomial and binary logistic regression to identify independent predictors of birth outcome and neonatal mortality respectively.ResultThe prevalence of pre-term and post term births was 8.1 % and 6.0 % respectively. Underweight maternal body mass index (RRR: 0.47, CI: 0.22–0.99), medium reported income (RRR: 0.26, CI: 0.12–0.5), length of neonate (RRR: 0.05, CI: 0.01–0.41), and multiple births (RRR: 2.86, CI: 1.4–5.650) were associated with pre-term birth. Predictors for post-term birth were overweight maternal body mass index (RRR: 3.88, CI: 1.01–15.05), high reported income mothers (RRR: 2.17, CI:1.1–4.3), as well as unmarried, widowed and divorced marital status (RRR:2.43, CI:1.02–5.80). With regards to binary logistic regression, pre-term birth (RR: 2.45, CI: 1.45–4.04) was an independent predictor for neonatal mortality, but this was not true for post-term births (RR: 0.45, CI: 0.07–2.96).ConclusionSocioeconomic and proximate factors are important predictors for pre-term and post-term births. Empowering women in terms of income status and controlling body mass index within the normal range are recommended. In addition, early detection and close antenatal follow-ups for mothers, who are at risk before and during pregnancy, are necessary to prevent both pre-term and post-term births.
Highlights
Pre-term and post-term births are major determinants of neonatal mortality, including short- and long-term morbidity
Socio-economic and demographic characteristics of participants Over half (57.2 %) of the mothers were between 25–35 year
Predictors of pre-term and post-term birth On multiple multivariable analyses, using hierarchical modeling of variables, we found body mass index (BMI) of the mother, Table 1 Association of selected socio-demographic characteristics with preterm and post term births on neonates delivered in Tigray, northern Ethiopia, April-July, 2014
Summary
Pre-term and post-term births are major determinants of neonatal mortality, including short- and long-term morbidity. This study measured the incidence and identified risk factors of pre-term birth and post-term births in Ethiopia. It examined the effects of pre-term and post-term birth on neonatal mortality. Pre-term and post-term births are defined as live births occurring at less than 37 weeks and at 42 or more weeks, respectively, and are associated with both shortand long-term childhood mortality and morbidities [1,2,3,4,5]. The prevalence of pre-term and postterm births are estimated to be 10 % and 5–10 %, respectively [6, 7]. Its prevalence and risk factors depends on geographic and demographic features of the population
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