Prevalence and associated risk factors of preterm and post-term births in Northern Ghana: a retrospective study in Savelugu Municipality

Abstract

ABSTRACTIntroductionPreterm and post-term births are prominent leading causes of neonatal mortalities and significant contributors to long-term adverse health outcomes. Although preterm and post-term births are disproportionately rampant in most parts of Ghana, the magnitude and underlying predictors are not well comprehended which necessitates more evidence for appropriate interventions. This study assessed the prevalence and identified vital risk factors of preterm and post-term births in Northern Ghana.MethodsThis study is a retrospective cross-sectional design conducted on 356 postnatal mothers from February to March 2022 in Savelugu Municipality of Northern Region, Ghana. Anthropometric, clinical, obstetric, and sociodemographic data were collected from antenatal records using structured questionnaires. Multinomial logistic regression was used to identify independent factors of preterm and post-term births at 95% confidence interval.ResultsPrevalence of preterm and post-term births were 19.4% and 6.5% respectively. Anaemia in the first trimester of pregnancy (AOR: 2.205; 95%CI: 1.011− 4.809), non-use of insecticide-treated bed nets (ITNs) during pregnancy (AOR:1.979; 95%CI: 0.999 − 3.920), maternal age less than 20 years (AOR:12.95; 95%CI: 2.977 − 56.34), and mothers with junior high school education (AOR: 0.225; 95%CI: 0.065 − 0.797) were independently associated with preterm births.Predictors for post-term births were macrosomic (large birthweight) delivery (AOR:8.128; 95%CI: 1.777 − 37.18) and mothers with senior high school education (AOR:0.001; 95%CI: 0.0001 − 0.125).ConclusionPreterm births are very prevalent, while post-term births are increasingly becoming crucial in the municipality. These nutritional (gestational anaemia) and non-nutritional (ITNs use, teenagers, maternal education, and macrosomic births) predictors of preterm and post-term deliveries are modifiable and preventable. Therefore, interventions should be targeted at intensified community education on nutrition and lifestyle modifications, in addition to vigorous promotion of girls’ child education through parental empowerment.KEY MESSAGESGlobally, most studies do not consider a wider spectrum of variables to identify risk factors of preterm and post-term births while few researchers consider studies on post-term births. Although preterm and post-term births are disproportionately common in some parts of Ghana, the magnitude and underlying determinants are not well understood which requires more evidence for suitable interventions in Northern Region and Ghana at large.We found the prevalence of preterm and post-term births to be relatively high in the Savelugu municipal. Prominent nutritional and non-nutritional factors were identified to be responsible for the delivery of preterm and post-term babies.To achieve better pregnancy outcomes, the promotion of girl child education through parental empowerment, rigorous community nutrition education, and lifestyle modification are recommended.