Preterm delivery in Ilorin: multiple and teenage pregnancies as major aetiological factors

Abstract

This study reports the aetiological factors responsible for 291 preterm births among 5019 deliveries at the University of Ilorin Teaching Hospital (UITH) during a 12-month period. It was found that although preterm babies made up 5.8% of all deliveries, they were responsible for 42% perinatal deaths. Important aetiological factors predisposing to preterm delivery included multiple pregnancy in 41.2% and primiparity in 23.4%. One-fifth of the primiparous were teenage mothers. Other factors included premature rupture of membrane, antepartum haemorrhage, grandmultiparity and eclampsia. It is suggested that early identification, monitoring and intervention in these high risk groups will improve gestational duration thereby reducing morbidity and mortality associated with preterm deliveries.

PIP: During August 1989-July 1990 in Nigeria, clinicians collected data on the 291 preterm births (5.8% of all deliveries) at the University of Ilorin Teaching Hospital so that a pediatrician could identify the factors associated with preterm delivery. 9.8% of all deliveries were low birth weight (LBW). Of the LBWs, 59.1% were preterm. Preterm deliveries comprised 42% of perinatal deaths and 61.2% of all neonatal deaths. The leading etiologic factors of preterm delivery included multiple pregnancy (41.2%) and primiparity (23.4%). 20.1% of primiparous cases were teenagers. Other etiologic factors were premature rupture of membrane (8.9%), antepartum hemorrhage (8.6%), grandmultiparity (5.8%), eclampsia (all but 1 were primiparous, 3.2%), and hypertension (2.7%). No cause was evident in 18 (5.2%) preterm cases. In Lagos, there are ethnic groups with a very high twinning rate (35.1/1000). These findings suggest the need for early identification, monitoring, and intervention in the high risk groups to improve gestational duration, which in turn reduces morbidity and mortality linked to preterm deliveries.