Abstract
Objective:To explore the incidence of preterm delivery, maternal risk factors for having a preterm neonate, and preterm neonates’ mortality in Jordan.Materials and Methods:A cross-sectional population-based design was applied. Socio-demographic, perinatal, delivery risk factors, and survival information were gathered in pre- and post-hospital discharge interviews with 21075 women who gave birth to live neonates at ≥20 weeks of gestation in 18 hospitals in Jordan. Women were interviewed between 2012 and 2013. The sample was limited to singleton women who gave birth to live neonates. Women who gave birth to stillborn babies were excluded.Results:Preterm delivery incidence was 5.8%, of which 85% were in 32-36 gestational weeks. Male sex, primigravidity, hypertension, preeclampsia, and diabetes were significantly associated with an increased risk of preterm delivery. Women aged 20-35 years had the lowest risk of preterm delivery. Mother’s weight <50 kg, hospitalization at 24-34 gestational weeks, lack of antenatal care visits or <8 visits during pregnancy, a history of preterm delivery, and a history of stillbirth/neonatal death were associated with increased risks of preterm delivery. The neonatal mortality rate was 4/1000 live births among full-term and 123/1000 live births among preterm babies. Prematurity, congenital anomalies, and maternal diseases were the causes of 84% of preterm neonatal deaths.Conclusion:The mortality rate was considerably higher among preterm neonates than among term neonates; discrepancies between Jordan and other countries existed. Systematic prenatal risk assessment and quality postnatal health care improvements are required to improve the survival rates of preterm neonates.
Highlights
Prematurity presents a significant challenge to the global community due to the rapid increase in its incidence and its disproportionate contribution to increased infant mortality rates
The study was conducted at 18 maternity hospitals that were carefully selected based on criteria determined by the study’s technical committee, which consisted of representatives from the United Nations International Children’s Emergency Fund (UNICEF), the World Health Organization (WHO), and the Jordanian health sectors
Less than one-third (32%) of women had an education level that was lower than high school, and 41.5% had an income of >350 Jordanian dinar (JD) per month (1 $= 0.71 JD)
Summary
Prematurity presents a significant challenge to the global community due to the rapid increase in its incidence and its disproportionate contribution to increased infant mortality rates. Among all neonatal deaths in 2013, 35% were caused by preterm birth complications alone[2]. Research that expands our understanding of the causes and risk factors of preterm birth and how to identify women and adolescents at risk is needed to decrease the global neonatal mortality rate[1]. Evidence regarding the incidence, geographic distribution, associated factors, and mortality risks of preterm births in Jordan is limited; these are mostly deduced from single settings or confined to data from limited geographic areas[6,7,8,9,10,11,12,13,14]. The purpose of this paper was to report the incidence of preterm birth, its risk factors, and its contribution to neonatal mortality
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