Abstract

Objectives: To identify and study the prevalence of maternal risk factors causing preterm labour.

Materials and Methods: This is a cross sectional study of 230 women, who had singleton live pregnancies at a gestational age between 24 weeks to 36 weeks 6 days , who came in spontaneous  true preterm labour.

Results: Moderately prevalent (10-25% prevalence) risk factors observed were periodontal infections, PPROM, cervical incompetence, history of previous cesarean section, short interpregnancy interval, placental abnormalities and fetal malpresentations. Other factors like maternal anemia, polyhydramnios, congenital uterine anomalies, congenital fetal anomalies, previous history of preterm delivery and low pre pregnancy BMI, had a low prevalence (<10%) in preterm labour.

All the study participants delivered with majority undergoing vaginal delivery. Birth weights correlated against early and late preterm births, were found to be statistically significant (p-0.02). The perinatal morbidity was 78.3% and majority were admitted in intensive care unitfor reasons  like low birth weight care, respiratory distress syndrome , birth asphyxia, hyperbilirubinemia , sepsis , meconium aspiration and intraventricular hemorrhage. The overall perinatal mortality in our study was 10.4% and it was significantly (p<0.001) associated with early preterm births.

Conclusion: Pretermlabour can occur spontaneously due to many factors, many of which are preventable, like maternal obesity/underweight, genitourinary infections, short interpregnancy interval. Also, with adequate knowledge, other risk factors can also be detected early in pregnancy and appropriately managed, so that preterm labour can be prevented. Thereby, the maternal and perinatal outcome can be improved and perinatal mortality rates can be brought down tremendously.

Keywords: Preterm labour; bacterial vaginosis; cervical incompetence; polyhydramnios; hyperbilirubinemia; meconium aspiration.