Identification of Risk Factors for Preterm Birth in a Regional Hospital in Northern Region of Sudan—A Prospective Study

Introduction: Preterm birth (PTB) (delivery< 37 completed weeks of gestation) is one of the leading causes of neonatal mortality and morbidity. Its aetiology is multifactorial but is unknown in many cases. Worldwide about 15 million babies are born preterm annually. Rates are higher in low and middle-income countries where several social, environmental and health factors interact. Objectives: The aim of this study was to identify factors associated with PTB in a metropolitan area of a low middle income country- Sudan. Method: This was a prospective cross-sectional hospital-based study carried out at Omdurman Maternity Hospital over a period of six months on women who received antenatal care and delivered at the hospital over the study period. After delivery, the cohort was then divided into those who delivered preterm and those who delivered at term, and a multivariate analysis performed to identify factors associated with PTB. Those who had elective CS were excluded from the study. Result: A total of 411 women received antenatal care and delivered over the study period and 384 formed the subjects of the study. The PTB rate was 7.4%. Factors identified that were associated with PTB included maternal age <20 years old (P=0.017), low family income (P=0.005), rarely receiving iron and folic acid supplementation (P=0.00001), infrequent antenatal care attendance (P=0.013), poor nutritional status (P=0.0000001), low maternal education (P=0.04) and short inter-pregnancy interval (<6 months) (P=0.04). Other factors included multiple birth (P=0.001), diabetes mellitus (P=0.004), antepartum haemorrhage (P=0.002), hypertension (P=0.004), previous PTB (P=0.0001) and urinary tract infections (P= 0.004). Conclusion: Various sociodemographic factors and complications during pregnancy increased the risk of PTB in this population. To reduce the risk, an interdisciplinary approach must be adopted. This should tackle factors pre-pregnancy and improve access. Healthcare providers should ensure folate and iron supplementation and identify complications such as diabetes and hypertensive disorders in pregnancy early and manage appropriately.