Maternal, obstetric and gynecological factors associated with preterm birth in Rwanda: findings from a national longitudinal study

Erigene Rutayisire; Monica Mochama; Corneille Killy Ntihabose; Jean Nepo Utumatwishima; Michael Habtu

doi:10.1186/s12884-023-05653-y

Maternal, obstetric and gynecological factors associated with preterm birth in Rwanda: findings from a national longitudinal study

BMC Pregnancy Childbirth. 2023 May 19;23(1):365. doi: 10.1186/s12884-023-05653-y.

Authors

Erigene Rutayisire¹, Monica Mochama², Corneille Killy Ntihabose³, Jean Nepo Utumatwishima^{4

5}, Michael Habtu⁶

Affiliations

¹ College of Medicine and Health Sciences, School of Public Health, University of Rwanda, Kigali, Rwanda. rerigene@yahoo.com.
² Public Health Department, Mount Kenya University, Kigali, Rwanda.
³ Department of Clinical and Public Health Services, Ministry of Health, Kigali, Rwanda.
⁴ Rwamagana Level Two Teaching Hospital, Ministry of Health, Kigali, Rwanda.
⁵ Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁶ College of Medicine and Health Sciences, School of Public Health, University of Rwanda, Kigali, Rwanda.

Abstract

Background: Preterm birth is one of the key causes of morbidity and mortality among neonates in low-income countries. In Rwanda, at least 35,000 babies are born prematurely each year, and 2600 children under the age of five die due to direct complications of prematurity each year. A limited number of studies have been conducted locally, many of which are not nationally representative. Thus, this study determined the prevalence as well as the maternal, obstetric, and gynecological factors associated with preterm birth in Rwanda at the national level.

Methods: A longitudinal cohort study was conducted from July 2020 to July 2021 among first-trimester pregnant women. A total of 817 women from 30 health facilities in 10 districts were included in the analysis. A pre-tested questionnaire was used to collect data. In addition, medical records were reviewed to extract relevant data. Ultrasound examination was used to assess and confirm gestational age on recruitment. A multivariable logistic regression analysis was performed to determine the independent maternal, obstetric, and gynecological factors associated with preterm birth.

Results: The prevalence of preterm births was 13.8%. Older maternal age- 35 to 49 years [Adjusted odds ratio (AOR) = 2.00; 95% Confidence Interval (CI) = 1.13-3.53)], secondhand smoke exposure during pregnancy (AOR = 1.91; 95% CI = 1.04-3.51), a history of abortion (AOR = 1.89; 95% CI = 1.13-3.15), premature membrane rupture (AOR = 9.30; 95% CI = 3.18-27.16), and hypertension during pregnancy (AOR = 4.40; 95% CI = 1.18-16.42) were identified as independent risk factors for preterm birth.

Conclusion: Preterm birth remains a significant public health issue in Rwanda. The associated risk factors for preterm birth were advanced maternal age, secondhand smoke, hypertension, history of abortion, and preterm membrane rupture. This study therefore recommends routine antenatal screening to identify and closely follow-up of those high-risk groups, in order to avoid the short- and long-term effects of preterm birth.

Keywords: First-trimester; Longitudinal cohort study; Preterm birth; Risk factors.

MeSH terms

Child
Female
Fetal Membranes, Premature Rupture* / epidemiology
Humans
Hypertension*
Infant, Newborn
Infant, Premature
Longitudinal Studies
Pregnancy
Premature Birth* / epidemiology
Risk Factors
Rwanda / epidemiology
Tobacco Smoke Pollution*

Substances

Tobacco Smoke Pollution