Assessment of Preterm Birth and Predictive Factors at Ayder Comprehensive Specialized Hospital, Northern Ethiopia: An Ordinal Logistic Regression Analysis

Abstract

Background: Preterm birth is a major public health concern due to its important impact on infant mortality and morbidity. Previous studies conducted in Ethiopia have examined the prevalence and risk factors of preterm birth, using a binary outcome of preterm birth, without considering the severity of preterm birth. Objective: -To assess Predictive Factors of Preterm Birth severity at Ayder Comprehensive Specialized Hospital, North Ethiopia from 2018 to 2020. Methods: A facility-based retrospective cross-sectional study was conducted among 2082 preterm and term neonates from February 2018 to May 2020 at Ayder Comprehensive Specialized Hospital. The minimum sample size was 538. All preterm and term neonates were included in this study. Ordinal logistic regression with partial proportional odd model (PPOM) was used to determine predictors of preterm. Parallel line assumption was tested using Brant test. Odd Ratio with 95% confidence interval was used to assess the strength of association between independent and dependent variables. Result- The overall prevalence of preterm was found to be 36.7% (95%C. I:34.67, 38.86). Being having congenital malformation the odd very preterm versus (moderate preterm, late preterm and term) increased by OR= 2.295(95% C.I :1.566,3.363) times. Being having multiple gestation the odd very preterm versus (moderate preterm, late preterm and term) increased by OR= 2.319(95% C.I:1.526,3.524) times, Being having history of preterm birth the odd very preterm versus (moderate preterm, late preterm and term) increased by OR= 10.03(95% C.I:6.803,14.788). Being having hypertension the odd having higher preterm level increased by OR= 3.835(95% C.I:2.036,7.226). Being having ANC visit the odd of having higher preterm level decreased by 91.8% OR= 0.182(95% C.I:0.039,0.841). Conclusions and Recommendations- in the PPOM, the variables congenital malformation, multiple gestation, history of preterm birth, hypertension, and malaria infection, had a positive significant association with the odd of preterm birth, whereas ANC visit had a negative significant effect. In order to decrease the probability of preterm birth, every mother should prevent chronic disease by changing life style. Health professional should provide health education, early screening of chronic disease and aware mothers to have appropriate ANC follow up during prenatal period.