Iranian Journal of Neonatology

Iranian Journal of Neonatology

Maternal Risk Factors and Outcomes of Premature Neonates Admitted to the Neonatal Care Unit in Al-Elwiya Pediatric Teaching Hospital in Baghdad, Iraq

Document Type : Original Article

Authors
Safaa Ibrahim Mohammed 1
Ali Abdul Razzak Obaid 2
Ban Abdulhameed Majeed 2
1 Department of Family Medicine, Kirkuk Public Health Central Laboratory, Kirkuk, Iraq
2 Al-Kindy College of Medicine, Department of Pediatrics, University of Baghdad, Baghdad, Iraq
10.22038/ijn.2022.61680.2176
Abstract
Background: Prematurity and its complications are the major causes of neonatal and infant morbidity and mortality. Although the cause of preterm labor is often unknown, numerous etiological risk factors may be implicated. To identify the risk factors that lead to prematurity and assess the neonatal outcomes that preterm neonates may develop.
Methods: This case-control study was conducted at AL-Elwiya Pediatric Teaching Hospital, Baghdad, Iraq, from the 1st of June to the 31st of December 2019. A non-randomized sample of 700 neonates admitted to the neonatal care unit was included in this study and divided into two groups of preterm full-term neonates as the experimental and control groups, respectively (n=350 each). The same questionnaire was applied to all cases. The test of proportion and the Chi-square test were used to determine significant differences between the two groups.
Results: A significant association was found between preterm birth and the factors of older maternal age (more than 35 years), passive smoking, low educational state, and employed mothers. Moreover, cervical incompetence, premature rupture of membrane, number of fetuses, and gestational hypertension showed significant associations with preterm birth. It was also found that preterm birth was highly associated with such complications as respiratory distress syndrome, sepsis, intraventricular hemorrhage, hypothermia, and hypoglycemia.
Conclusion: Prematurity was associated with certain risk factors, such as older maternal age, multiple gestations, premature rupture of membrane, pre-eclampsia, and diabetes mellitus. Preterm neonates were more liable to develop complications, have hospital admission, and have a higher risk of mortality than the control group.
 
 
Keywords
Causes
Complications
Newborn
Preterm
  1. World Health Organization. "Preterm birth Fact Sheet N°363" 2014. http://www.who.int/ mediacentre/factsheets/fs363/en. Accessed on 6/7/2021
  2. Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C. Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC pregnancy and childbirth. 2010; 10(1):1-22.
  3. Brumbaugh JE, Hansen NI, Bell EF, Sridhar A, Carlo WA, Hintz SR, et al. Outcomes of extremely preterm infants with birth weight less than 400g. JAMA Pediatr. 2019; 173(5):434-45.
  4. Di Stefano LM, Wood K, Mactier H, Bates SE, Wilkinson D. Viability and thresholds for treatment of extremely preterm infants: survey of UK neonatal professionals. Arch Dis Child Fetal Neonatal Ed. 2021; 106(6):596-602.
  5. Preterm Birth 2018. http://www.who.int/ news-room/fact-sheet/detail/preterm-birth.
  6. WHO report. 2010. http://data.un.org/Data.aspx? d=WHO&f=MEASURE_CODE%3aWHS_PBR.
  7. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010; 88(1):31–8.
  8. Hannah B, Julia K, Mercedes de O, Robert E, Xiaoyi A, Gretchen A, et al. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis. The Lancet. 2019; 7(7):849-60.
  9. Klidea SV, Gao Y, Rolfe M, Boyle J, Tracy S, Barclay LM. Risk factors for preterm, low birthweight and small for gestational age births among Aboriginal women from remote communities in Northern Australia. Women Birth. 2017; 30(5):398-405.
  10. Noritz ER, Caughey AB. Progesterone supplementation and the prevention of preterm birth. Rev Obstet Gynecol. 2011; 4(2):60-72.
  11. WHO and UNICEF. 2019 report, SURVIVE and THRIVE. 2021. http://www.unicef.org.
  12. Younes S, Samara M, Al Jurf R, Nasrallah G, AL Obaidly S, Salama H, et al. Incidence, risk factors, and outcomes of preterm and early term births: a population-based register study. Int J Environ Res Public Health. 2021; 18(11):1-14.
  13. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2016; 388(10063):
    3027–35.
  14. Al Assadi AF, Al Harron DS, Al Rubaye A, Abdul Rahman BA. Risk factors and neonatal outcome among preterm birth at Basrah central hospitals. Med j Basrah Univ. 2018; 36(2):87-96.
  15. Farhood AL Joborae SF, Alwan FW. Sociodemographic and medical factors of preterm delivery according to the clinical subtypes of prematurity. Med j Babylon. 2018; 15(4):341-8.
  16. Al Dabbagh SA, Al Taee WY. Risk factors for pre-term birth in Iraq: a case-control study. BMC Pregnancy and Childbirth. 2006; 6:1-7.
  17. Soltani M, Tabatabaee HR, Saeidinejat S, Eslahi M, Yaghoobi H, Mazloumiu E, et al. Assessing the risk factors before pregnancy of preterm births in Iran:
    a population-based case-control study. BMC Pregnancy Childbirth. 2019; 19:1-8.
  18. 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; 13(1):1-10.
  19. Hediger ML, Scholl TO, Schall JI, Krueger Young maternal age and preterm labor. Ann Epidemiol. 1997; 7(6):400-6.
  20. Cai C, Vandermeer B, Khurana R, Nerenberg K, Featherstone R, Sebastianski M, et al. The impact of occupational shift work and working hours during pregnancy on health outcomes: a systematic review and meta-analysis. Am J Obstet Gynecol. 2019; 221(6): 563-76.
  21. Taha Z, Hassan AA, Wikkeling Scott L, Papandreou D. Factors associated with preterm birth and low birth weight in abu dhabi, the united arab emirates. Int J Environ Res Public Health. 2020; 17(4):1-10.
  22. Gurung A, Wrammert J, Sunny AK, Gurung R, Rana N, Basaula YN, et al. Incidence, risk factors and consequences of preterm birth-findings from multicentric observational study for 14 months in Nepal. Archives of public health. 2020; 78:1-9.
  23. Liu B, Xu G, Sun Y, Qiu X, Ryckman KK, Yu Y, et al. Maternal cigarette use before and during pregnancy and the risk of preterm birth: a dose-response analysis of 25 million mother-infant pairs. PLoS Med. 2020;17(8):1-17.
  24. Vakilian K, Ranjbaran M, Khorsandi M, Sharafkhani N, Khodadost M. Prevalence of preterm labor in Iran: a systematic review and meta-analysis. Int J Reprod Biomed. 2015; 13(12):743-8.
  25. Oliver Williams C, Fleming M, Monteath K, Wood AM, Smith GCS. Changes in association between previous therapeutic abortion and preterm birth in scotland, 1980 to 2008: a historical cohort study. PLoS Med. 2013; 10(7):1-11.
  26. Al Saady LAK, Al Musawi Clinical study of respiratory distress syndrome in AL-Kadhimiya teaching hospital. Iraqi J Med Sci. 2012; 10(4):396-401.
  27. Patil S, Patil KP. Analysis of risk factors of late preterm birth: a case-control study. Indian J Med Res.2017; 10(3):283-7.
  28. Abdul Mumin A, Owusu SA, Abubakari A. Factors associated with treatment outcome of preterm babies at discharge from the neonatal intensive care unit (NICU) of the tamale teaching hospital, Ghana. Int J Pediatr. 2020; 2020:1-7.
  29. Aljawadi HF, Ali EA, Kareem SH. Preterm incidence with analytical assessment of causes and risk factors of mortality. J Babol Univ Med Sci. 2020; 22(1):101-9.
  30. Paudel L, Kalakheti B, Sharma K. Prevalence and outcomes of preterm neonates admitted to neonatal unit of a tertiary center in western nepal. J Lumbini Med Coll. 2018; 6(2):1-5.
Iranian Journal of Neonatology
Volume 13, Issue 3
Summer 2022
Pages 56-62