Submitted by:
Soumya V.C
Sija Chandran L.J.
Shaliet Rose Sebastian
Guided by:
Dr.K. Vijayakumar
ABSTRACT
BACKGROUND:
In developing countries like India, the incidence of preterm births is estimated to be around 20 to 25 %.Though infant mortality has shown an overall decline in the past three decades, the preterm segment of infant mortality has remained constant. A lot of factors associated with the development of morbidity are preventable. However an initiative to contain the problem is noted by its paucity. Lack of studies about the true determinants of morbidity in preterm infants especially in our setting prompted us to undertake this study.
OBJECTIVE:
The objective of this study is to identify the factors associated with the development of co-morbid conditions in preterm babies born at the Dept: of Obstetrics &Gynaecology, SAT Hospital, Thiruvananthapuram during 01.10.2008 to 30.11.2008.
METHODOLOGY:
We devised a case-control study to assess the factors associated with the development of co-morbid conditions in preterm infants.50 morbid preterm infants were taken as cases and 50 preterm infants who were not morbid were taken as controls .The data was collected by interviewing the mothers using a semi structured questionnaire and by studying the case records of the infants maintained at the Inborn Nursery. Data was analyzed statistically using Odds Ratio and Chi-square test for significance. Multiple Logistic Regression analysis was done following a forward stepwise method of elimination.
RESULTS:
Associated factors by univariate analysis were maternal blood group other than O group (OR=3.6(95%CI=1.5-8.4)), APGAR less than 6at1’ (OR=27.6(3.5-216.8)), not being given Breast-milk (OR=4.5(1.3-14.8)), administration of antenatal steroids (OR=3.2(1.4-1.2)), not cried soon after birth(0R=38.5(4.9-301.2)),male sex(OR=2.4(1.1-5.6)),gestational age less than 32weeks(OR=3.6(1.1-12.2)),birth weight less than 1500g(OR=3.2(1.2-8.5)), non exposure to tobacco smoke during pregnancy (OR=3.0(1.3-6.9)) fetal mal-presentation (OR=2.9(1-8.2)).After applying binary logistic regression, the following preterm babies were found to be at a higher risk of developing co-morbid conditions (adjusted Odds ratio and p value given)(R2=0.45):
a. Mother with previous history of abortions (OR=5.6, p=.044)
b. Mother with blood group other than Group (OR=7.7, p=.002)
c. Mother primi gravid (OR=4.9, p=.032)
d. (OR=41.6, p=.003)
e. APGAR less than 6at1’ (OR=16.8, p=.003 Not Cried Soon After Birth)
f. Non exposure to tobacco smoke (OR=9.4, p=.001)