A descriptive study on the risk factors of preterm birth with its maternal and fetal outcomes at a tertiary care hospital

Background: India contributes to greatest number of preterm births all over the world. The global annual prevalence of preterm birth ranges from 9-12%. It is the most common indication for antenatal hospitalization and is the leading cause for under-five mortality. Aims and objectives were to study the incidence, risk factors, clinical presentation, effectiveness of timely intervention and, maternal and fetal outcomes of preterm birth.Methods: A Prospective hospital based cross-sectional study was done from February 2021 to February 2022.Results: The incidence of preterm labour in the study was 24%. Majority of cases presented with symptoms of UTI (47%), vaginal discharge (43%) and leaking per vagina (13%). Infections were the most common aetiology, 40% of cases had positive urine and vaginal swab culture. The most common neonatal complications were respiratory distress syndrome (7%) and neonatal sepsis (7%), others included seizures (2%), birth asphyxia (1%), enterocolitis (1%), hypoxic ischemic encephalopathy (1%), intracranial hemorrhage (1%), meningitis (1%) and pulmonary hemorrhage (1%). 5% of neonatal deaths were noted.Conclusions: Urogenital infections were the commonest etiology for the onset of preterm labour, followed by gestational hypertensive disorders, previous history of preterm birth and anaemia in pregnancy. We conclude that in established preterm labour, aggressive management with antenatal corticosteroids, Magnesium sulphate for neuroprotection when indicated, antibiotic coverage and use of tocolytics with early in-utero transfer of mother to centres with equipped neonatal care units will improve the neonatal outcome.

Anthropometric surrogates to identify low birth weight babies: hospital based cross-sectional study

Background: Birth weight acts as a crucial sensitive and reliable tool to prevent infant and child morbidity and mortality. There has been a considerable interest in recent years for using simple anthropometric measures as an alternative to birth weight. Objective of the study is to determine the cut off values of the anthropometric measurements and to assess the accuracy of the anthropometric surrogates to identify low birth weight babiesMethods: This is a cross sectional study conducted for a period of one year from 1st Dec 2011 to 31st Nov 2012 at Christian fellowship hospital, Oddanchatram, Dindigal, Tamilnadu. Study population included all the live newborns of term gestation at the hospital. A total of 500 newborns were included in the study during the period. Birth weight of the newborn was measured using spring scale to the nearest 25 grams. Head circumference, Chest circumference, Mid Upper Arm Circumference, Foot Length, Thigh circumference, Calf circumference, Crown-hell length were measured using proper guidelines to the nearest 0.1 cm.Results: In the present study, low birth weight was present in 262 (52.4%) of the newborns. Thigh circumference with cut off value of 15 cm had higher sensitivity and specificity of 97.5% and 80.9% respectively. It was followed by Mid upper arm circumference with cut off value of 10 cm, sensitivity of 81.5% and specificity of 93.9%. Thigh circumference and mid upper arm circumference had high area under curve of 0.949 and 0.855 respectively. All the anthropometric measurements were statistically significant at 5% level of significance.Conclusions: Thigh circumference with a cut off of 15 cm, followed by mid upper arm circumference of 10 cm were the better surrogate anthropometric measurements with better sensitivity, specificity to identify low birth weight babies.