Determinants of preterm birth among newborns in resource limited settings

The World Health Organization defines preterm birth as any birth before 37 completed weeks of gestation, or fewer than 259 days since the first day of the woman's last menstrual period. Globally, 1 in 10 babies is born prematurely and more than a million babies are estimated to die annually. The determinants of preterm birth may vary from region to region within the same country due to variation in socioeconomic status and health care service coverage. Therefore, this study was designed to identify determinants of preterm birth among newborns born in selected public hospitals in west Guji, east Guji and Borana zones, southern Ethiopia. A facility based unmatched case control study was conducted on 241 (80 cases and 161 controls) newborns. Among 13 hospitals of study area, 8 hospitals were selected by lottery method and sample size was proportionally allocated for each hospital based on their two month delivery report of cases. For one case two controls were selected consecutively. A pretested structured interviewer administered questionnaire and maternal chart were used to collect data. Then the collected data were coded and entered in to Epi data version 3.1, and exported to the Statistical Package for Social Science (SPSS) version 25 for analysis. Both bi-variable and multivariable logistic regressions were used for analysis. Finally, adjusted odds ratio together with 95% confidence intervals and p value < 0.05 were used to declare the significance of association between independent variables and dependent variable. All mothers of newborns were included with the response rate of 100%. The result of multivariable analysis showed that; lack of antenatal care visit [AOR = 2.58, 95% CI (1.09-6.10)], ante partum hemorrhage [AOR = 3.46, 95% CI (1.29-9.23)], premature rupture of membrane [AOR = 5.54, 95% CI (1.89-16.20)], pregnancy induced hypertension [AOR = 5.77, 95% CI (1.65-20.21)], and multiple pregnancy [AOR = 5.87, 95 CI (1.6-21.7)] were determinants of preterm birth. The study indicates that a history of premature rupture of membranes, pregnancy-induced hypertension, antepartum hemorrhage, lack of antenatal care, and multiple pregnancies are identified as determinant factors for preterm birth. Early detection and effective management of obstetric complications are crucial in preventing the occurrence of preterm birth and its associated complications.