Table of Contents
DECLARATION ................................................................................Error! Bookmark not defined.
APPROVAL..........................................................................................................................................ii
DEDICATION.....................................................................................................................................iv
ACKNOWLEDGEMENT ....................................................................................................................v
LIST OF TABLES...............................................................................................................................ix
LIST OF FIGURES .............................................................................................................................ix
LIST OF ABBREVIATIONS...............................................................................................................x
OPERATIONAL DEFINITIONS........................................................................................................xi
ABSTRACT........................................................................................................................................xii
CHAPTER ONE: INTRODUCTION...................................................................................................1
1.1 Background .................................................................................................................................1
1.2 Problem statement.......................................................................................................................2
1.3 Justification .................................................................................................................................2
1.4 Broad objective ...........................................................................................................................3
1.4.1 Specific objectives of the study ...............................................................................................3
CHAPTER TWO: LITERATURE REVIEW.......................................................................................4
2.1 Introduction.................................................................................................................................4
2.2 Causes and Risk Factors .............................................................................................................4
2.2.1 Maternal Socio-Demographic Factors.....................................................................................5
2.2.2 Obstetric Risk Factors..............................................................................................................6
2.2.3 Fetal Factors.............................................................................................................................7
CHAPTER THREE: METHODOLOGY .............................................................................................9
3.1 Study Design...............................................................................................................................9
3.2 Study Area...................................................................................................................................9
3.3 Study Population.........................................................................................................................9
3.4 Sample Size Calculation .............................................................................................................9
vii
3.5 Eligibility Criteria .....................................................................................................................10
3.5.1 Inclusion criteria ....................................................................................................................10
3.5.2 Exclusion criteria ...................................................................................................................10
3.6 Sampling Method......................................................................................................................10
3.7 Data collection, analysis and presentation ................................................................................10
3.8 Ethical Considerations ..............................................................................................................10
CHAPTER FOUR: RESULTS ...........................................................................................................11
4.1 Description of participants characteristics................................................................................11
4.1.1 Characteristics of mothers......................................................................................................11
4.1.2 Neonatal Characteristics ........................................................................................................12
4.1.2.1 Birth Weights......................................................................................................................12
4.1.2.2 Gestational Age...................................................................................................................12
4.1.2.3 Sex of the Babies.................................................................................................................13
4.2 Prevalence of Preterm Birth......................................................................................................14
4.3 Socio-Demographic Factors......................................................................................................14
4.4 Previous Pregnancy Factors......................................................................................................15
4.5 Antenatal Factors ......................................................................................................................16
4.6 Delivery Factors........................................................................................................................17
4.7 Obstetric Factors.......................................................................................................................18
4.8. Independent Determinants of Preterm Birth ............................................................................19
CHAPTER FIVE.................................................................................................................................21
DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS....................................................21
5.1 DISCUSSION OF THE FINDINGS.........................................................................................21
5.1.1 Prevalence of preterm birth....................................................................................................21
5.1.2 Factors associated with preterm birth ....................................................................................21
5.2 CONCLUSIONS.......................................................................................................................24
5.3 RECOMMENDATIONS..........................................................................................................24
5.4 LIMITATIONS OF THE STUDY............................................................................................24
viii
REFERENCES....................................................................................................................................24
APPENDIX I: CONSENT FORM......................................................................................................28
APPENDIX II: QUESTIONNAIRE...................................................................................................29
APENDIXIII: INTRODUCTORY LETTER:……………………………………………………….32
APPENDIX IV:THE MAP OF KIRYANDONGO DISTRICT:……………………………………33
APPENDIX V: MAP OF UGANDA SHOWING KIRYANDONGO DISTRICT............................34
ABSTRACT Background: The World Health Organization (WHO) estimates the prevalence of preterm birth to be between 5% and 18% across 184 countries. Of the estimated 3 million neonatal deaths occurring globally each year, about 1 million are directly related to prematurity. Uganda has one of the highest preterm birth rates in the world estimated at 13.6 per 1000 live births and little was known about prevalence of preterm birth in Kiryandongo hospital. In order to realize a reduction in pre-term births, interventions that target the risk factors are paramount. Hence, this study was to explore the prevalence and risk factors of preterm birth in Kiryandongo general hospital. Methods: All mothers who had live births at Kiryandongo Hospital and their newborns were included in the study. Mothers were interviewed using a standard pretested questionnaire to identify factors associated with preterm birth. Data was analyzed using excel analysis package version 2016 and a pvalue < 0.05 was considered significant. Results: A total of 154 mother-baby pairs were enrolled into the study. The mean maternal age was 26±5 years while most mothers (83%) were married and had attained primary level of education or below (85%). The prevalence of preterm birth in this study was found to be 18.3% (95% CI of 14.1- 22.5). Parity ≥ 4, previous preterm birth, multiple gestation, pregnancy induced hypertension (PIH), antepartum hemorrhage (APH), prolonged preterm prelabor rupture of membranes (PPROM) and urinary tract infection (UTI) in pregnancy were all significantly associated with preterm birth (p=
