Analysis Of Risk Factors Of Late Preterm Birth: A Case Control Study

Abstract

Objective To identify the risk factors associated with late preterm births. Methodology This case control study was conducted in Department of Obstetrics and Gynecology, teaching hospital attached to KLE University’s Jawaharlal Nehru Medical College, Belagaviduring the period of May 2015- April 2016. A total of 918 women were enrolled, 459 in each group. Women who delivered between 34 – 36+6 weeks were considered as cases and controls were women who delivered from 37 weeks onwards immediately after a case occured. Gestational age was confirmed with USG prior to 20 weeks. Data was collected from the history of the patient and the medical records. Result Incidence of late preterm birth was found to be 8% among total births. It was found that 55.1% were spontaneous births. The most common risk factor for late preterm birth was Hypertensive disorders of pregnancy (Gestational HTN- 4.8%, Chronic HTN – 5%, PE – 36%, Eclampsia – 4.8%) followed by PPROM (32.7%), History of prior preterm births (19.2%), Gestational diabetes (17.9%), Multifetal gestation (16.6%), Placenta previa (13.5%) and Abruptio placenta (9.8%). On analyzing neonatal outcome, Sepsis was found in 25%, Hyperbilirubinemia in 21.9%, RDS in 19%, Transient tachypnoea of newborn in 09% and PDA in 2.9% of the neonates. Conclusion The indication for the induction or need for termination should be reevaluated in the late preterm gestation. In order to prevent late preterm birth, identification of the risk factors is necessary and timing of delivery in each risk factor should be reassessed in advance before intended intervention. As LPB constitute majority of preterm births, it is important to limit late preterm deliveries to clear maternal or fetal indication for delivery