Published: 2021-04-27

Medical and obstetric factors associated with preterm deliveries among women of childbearing age at Pumwani maternity hospital, Nairobi County, Kenya

Daniel K. Mwangi, Stanley K. Waithaka, Alfred O. Odongo


Background: The rate of pre-term birth (PTB) in Kenya stands at 12.3%. Preterm deliveries are associated with high neonatal mortality and have a huge financial burden on the parents and the government. Prematurity is also associated with chronic diseases like diabetes and hypertension in adult life. The study objective was to determine the medical1and obstetric factors1associated1with preterm deliveries among women of childbearing age (15-49 years) at Pumwani maternity hospital (PMH).

Methods: A hospital-based cross-sectional study was conducted among 191 mothers of reproductive age (15-49 years) who delivered at PMH during the study period. Data was collected using a questionnaire and a data abstraction tool. Descriptive statistics were used to summarize categorical variables. Chi-square was used to test for the strengths of associations. Prevalence adjusted odds ratios (PAOR) were used to estimate the strengths of associations.

Results: The study found that the association between past pregnancy (p=1.0), history of surgery (p=1.0), medication (p=1.0), urinary tract infection (p=0.453), miscarriage (p=1.0) and chronic disease (p=0.395) and preterm delivery among women of child bearing age (15-49 years) at PMH was not statistically significant. The association between premature delivery (p=0.021), parity (p=0.000), premature rapture of membranes (PROM) (p=0.000), antepartum hemorrhage (APH) (p=0.045), cervical incompetence (p=0.001), pre-eclampsia toxemia (PET) (p=0.000), and placenta abruption complications (p=0.009) and preterm delivery was statistically significant.

Conclusions: The association between premature delivery, parity, PROM, APH, cervical incompetence, PET and placenta abruption complications and preterm delivery was statistically significant.


Medical1and obstetric factors, Preterm deliveries, APH

Full Text:



Blencowe H, Cousens S, Oestergaard M, Chou D, Moller A, Narwal R. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012;379(9832):2162-72.

Marchant T, Willey B, Katz J, Clarke S, Kariuki S, Ter Kuile F et al. Neonatal mortality risk associated with preterm birth in East Africa, adjusted by weight for gestational age: individual participant level meta-analysis. PLoS Med. 2012;9(8):100-29.

CP Howson, MV Kinney, JE Lawn March of Dimes, PMNCH, Save the Children W. Born too soon. Born Too Soon, The Global action Report on Preterm Birth. World Health Organization. Geneva. 2012;13(5):1-126.

Howson P, Kinney V, McDougall L, Lawn E. Born too soon: preterm birth matters. Reprod health. 2013;10(1):1-9.

Lawn E, Blencowe H, Oza S, You D, Lee C, Waiswa P et al. Every Newborn: progress, priorities, and potential beyond survival. Lancet. 2014;384(9938):189-205.

Purisch E, Gyamfi-Bannerman C. Epidemiology of preterm birth. InSeminars in perinatol. 2017;41(7):387-91.

Wagura P, Wasunna A, Laving A, Wamalwa D. Prevalence and factors associated with preterm birth at Kenyatta National Hospital. BMC preg childbirth. 2018;18(1):1-8.

World Health Organization. World health statistics 2016: a wealth of information on global public health. World Health Organization 2016. Available from _health_statistics/2016/EN_WHS2016_TOC.pdf. Accessed on 3 March 2020.

Lopez M, Figueras F, Hernandez S, Lonca M, Garcia R, Palacio M et al. Association of HIV infection with spontaneous and iatrogenic preterm delivery: effect of HAART. Aids. 2012;26(1):37-43.

Van den Broek R, Jean-Baptiste R, Neilson P. Factors associated with preterm, early preterm and late preterm birth in Malawi. PloS one. 2014;9(3):90128.

Gondwe A, Munthali C, Ashorn P, Ashorn U. Perceptions and experiences of community members on caring for preterm newborns in rural Mangochi, Malawi: a qualitative study. BMC preg childbirth. 2014;14(1):1-9.

Morgan K. Role of the placenta in preterm birth: a review. Am J perinatal. 2016;33(03):258-66.

Orbach H, Matok I, Gorodischer R, Sheiner E, Daniel S, Wiznitzer A et al. Hypertension and antihypertensive drugs in pregnancy and perinatal outcomes. Am J obstetr gynecol. 2013;208(4):301-21.

Mahande J, Daltveit K, Obure J, Mmbaga T, Masenga G, Manongi R et al. Recurrence of preterm birth and perinatal mortality in northern Tanzania: registry‚Äźbased cohort study. Trop Med Int Health. 2013;18(8):962-7.

Immer F, Bansi G, Immer-Bansi S, McDougall J, Zehr J, Schaff H. Aortic dissection in pregnancy: analysis of risk factors and outcome. Ann Thoracic Surg. 2003;76(1):309-14.

Do Carmo M, Esteves-Pereira P, Nakamura-Pereira M, Torres A, Theme-Filha M, Domingues M et al. Prevalence and risk factors related to preterm birth in Brazil. Reprod health. 2016;13(3):163-74.

Temu TB, Masenga G, Obure J. Maternal and obstetric risk factors associated with preterm delivery at a referral hospital in northern-eastern Tanzania. Asian Pacific J Reprod. 2016;5(5):365-70.

World Health Organization.The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Available from Accessed on 10 May 2020.

Abaraya M, Seid SS, Ibro SA. Determinants of preterm birth at Jimma university medical center, Southwest Ethiopia. Pediatr health, med therap. 2018;9:101.

Ghaheh HS, Feizi A. Risk factors of placental abruption. Journal of research in medical sciences. J Isfahan University of Med Sci. 2013;18(5):422.