Behavioural And Socio-Demographic Factors Associated With Preterm Birth Among Women Who Deliver In Public Hospitals In Windhoek, Namibia.

ABSTRACT

Preterm birth, the birth of an infant prior to 37 completed weeks of gestation is the leading cause of newborn deaths in their first four weeks of life. In addition to its contribution to mortality, preterm birth has lifelong effects on neuro-developmental functioning such as increased risk of cerebral palsy, impaired learning and visual disorders, and an increased risk of chronic disease in adulthood that often result in huge physical, emotional and economic cost. In Namibia the prevalence of preterm birth is very high. Although preterm birth is a challenge in Namibia, little is known about the causes; therefore this research is an attempt to fill in that gap.

The purpose of this study was to determine behavioural and socio-demographic factors associated with preterm birth among women who deliver at Windhoek Central Hospital (WCH) and Intermediate Hospital Katutura (IHK). A quantitative, observational, analytic case control study design was conducted on 100 women with preterm birth (case group) and 300 women with full term birth (control group), who were interviewed using a structured interview schedule between 01 October 2016 and 30 November 2016. A number of potential exposure variables were investigated and data was analysed using Epi Info software version 7.1.3.0 and Statistical Package for Social Sciences (SPSS) version 24. Both descriptive and statistical analysis were employed. Statistical analysis was performed by univariate analysis and multivariable logistic regression analysis.

Univariate analysis showed that body mass index, age, marital status, education level, work type, antenatal care visits, supplementary tablets intake, inter-pregnancy interval, pregnancy intendedness, staying with smokers and partner smoking were associated with birth term. Multivariable logistic regression analysis revealed that highest level of education, inter-pregnancy spacing interval, work type, BMI, staying with smokers and partner smoking were

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significantly associated with birth term even after adjustment for the effects of other variables.

The factors that were found to be risk factors for preterm birth included, low pre-pregnancy BMI, being single or divorced, young and old maternal age, low education level, strenuous work, maternal alcohol drinking, short and long inter-pregnancy spacing intervals, lack of antenatal care and supplementary tablets intake, having unwanted pregnancies and staying with smokers. Most of the risk factors for preterm birth in this study stem from behaviours. Maternal behaviour change interventions are needed in Windhoek in order to reduce the prevalence of preterm birth.