Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Shahid Faghihi Hospital, Shiraz, Iran

2 Department of Public Health, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Mother and Child Welfare Research Center, Faculty of Nursing and Midwifery, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

Abstract

BACKGROUND: Preterm birth (PTB) is one of the most important factors that increase the risk of
chronic diseases and postpartum death in infants. The aim of this study was to determine the maternal
factors that affect the birth of preterm infants in the city of Bandar Abbas.
MATERIALS AND METHODS: This is a case–control study that was performed on 400 preterm
infants. Sampling was done by a simple method, and information was gathered by interviewing the
mothers and their medical records. Data were collected by SPSS software version 16. To compare
risk factors in the two groups, conditional logistic regression was used, and P < 0.05 was considered
statistically significant.
RESULTS: Results showed that factors such as type of delivery (odds ratio [OR] = 3.584, 95%
confidence interval [CI]: 1.981–6.485), preeclampsia (OR = 2.688, 95% CI: 1.164–6.207), history
of PTB (OR = 4.171, 95% CI: 1.483–11.728), premature rupture of membranes (OR = 3.273,
95% CI: 1.745–6.137), care during prenatal (OR = 0.334, 95% CI: 0.159–0.701), placental
abruption (OR = 3.209, 95% CI: 1.209–8.519), placenta previa (OR = 9.333, 95% CI: 2.086–41.770),
and cervical insufficiency (OR = 11, 95% CI: 1.381–87.641) were independent risk factors of preterm
infant birth.
CONCLUSIONS: The PTB risk is higher for women with cervical insufficiency, history of placenta
previa, and history of preterm. Early recognition and management of these high‑risk conditions among
pregnant women may lead to a reduction in PTB rates.

Keywords

1. Amini P, Maroufizadeh S, Samani RO, Hamidi O,  Sepidarkish M. Prevalence and determinants of preterm birth
in Tehran, Iran: A comparison between logistic regression
and decision tree methods. Osong Public Health Res Perspect
2017;8:195‑200.
2. Ayebare E, Ntuyo P, Malande OO, Nalwadda G. Maternal,
reproductive and obstetric factors associated with preterm births
in Mulago Hospital, Kampala, Uganda: A case control study. Pan
Afr Med J 2018;30:272.
3. Murray CJ, Vos T, Lozano R, Naghavi M, Flaxman AD,
Michaud C, et al. Disability‑adjusted life years (DALYs) for
291 diseases and injuries in 21 regions, 1990‑2010: A systematic
analysis for the Global Burden of Disease Study 2010. Lancet
2012;380:2197‑223.
4. Howson CP, Kinney MV, McDougall L, Lawn JE, Born Too Soon
Preterm Birth Action Group. Born too soon: Preterm birth matters.
Reprod Health 2013;10 Suppl 1:S1.
5. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global,
regional, and national causes of child mortality in 2000‑13, with
projections to inform post‑2015 priorities: An updated systematic
analysis. Lancet 2015;385:430‑40.
6. Safari Moradabadi A, Rajaei M, Naderi S. Investigating the
underlying causes of mortality among less than one year old
infants in pediatric hospital of Bandar Abbas, Iran. Hormozgan
Med J 2014;18:180‑6.
7. Wagura P, Wasunna A, Laving A, Wamalwa D, Ng’ang’a P.
Prevalence and factors associated with preterm birth at Kenyatta
National Hospital. BMC Pregnancy Childbirth 2018;18:107.
8. Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al.
Global, regional, and national causes of child mortality: An
updated systematic analysis for 2010 with time trends since 2000.
Lancet 2012;379:2151‑61.
9. Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al.
The worldwide incidence of preterm birth: A systematic review
of maternal mortality and morbidity. Bull World Health Organ
2010;88:31‑8.
10. Chang HH, Larson J, Blencowe H, Spong CY, Howson CP,
Cairns‑Smith S, et al. Preventing preterm births: Trends and
potential reductions with current interventionsin 39 very high
human development index countries. Lancet 2013;381:223.
11. Gebreslasie K. Preterm birth and associated factors among
mothers who gave birth in Gondar Town Health Institutions.
Adv Nurs 2016;2016;1‑5.
12. Dadipoor S, Madani A, Alavi A, Roozbeh N, Safari Moradabadi A.
A survey of the growing trend of caesarian section in Iran and
the world: A review article. Iranian J Obstet Gynecol Infertil
2016;19:8‑17.
13. Klebanoff MA, Keim SA. Epidemiology: The changing face of
preterm birth. Clin Perinatol 2011;38:339‑50.
14. Dadipoor S, Rajaei M, Naderi S, Ghanbarnejad A,
Safari Moradabadi A. Investigating causes of infant mortality
in hospital of children during 2010‑2011 in Bandar Abbas. Iran J
Neonatol 2014;5:28‑33.
15. Tracy S, Tracy M, Dean J, Laws P, Sullivan E. Spontaneous
preterm birth of liveborn infants in women at low risk in Australia
over 10 years: A population-based study. BJOG 2007;114:731‑5.
16. Salem Yaniv S, Levy A, Wiznitzer A, Holcberg G, Mazor M,
Sheiner E. A significant linear association exists between advanced
maternal age and adverse perinatal outcome. Arch Gynecol Obstet
2011;283:755‑9.
17. Nia ZK. Prevalence and maternal risk factors of preterm laboring
in Qom, 2007. Qom Univ Med Sci 2012;5:30‑36.
18. Safari Moradabadi A, Alavi A, Eqbal Eftekhaari T, Dadipoor S.
The reproductive behavior of families with thalassemic children
in Hormozgan. J Reprod Infertil 2015;16:167‑70.
19. Mokuolu OA, Suleiman B, Adesiyun O, Adeniyi A. Prevalence
and determinants of pre‑term deliveries in the University of Ilorin
Teaching Hospital, Ilorin, Nigeria. Pediatr Rep 2010;2:e3.
20. Dadipoor S, Alavi A, Pormehr‑Yabandeh A, Golnam M,
Safari‑Moradabadi A. Investigation on some maternal factors
affecting the birth of preterm infants: A case–control study. Feyz
J Kashan Univ Med Sci 2017;20:551‑556.
21. Namakin K, Sharifzadeh G, Malekizadeh A. To identify the risk
factors in prematurity birth in Birjand, Iran: A case‑control study.
Iran J Epidemiol 2011;7:1‑5.
22. Bekele T, Amanon A, Gebreslasi K. Pre‑term birth and associated
factors among mothers who gave birth in Debremarkos town
health institutions, 2013 institutional based cross sectional study.
Gynecol Obstet 2015;5:292‑7.
23. Rao CR, de Ruiter LE, Bhat P, Kamath V, Kamath A, Bhat V.
A case‑control study on risk factors for preterm deliveries in a
secondary care hospital, southern India. ISRN Obstet Gynecol
2014;2014:935982.
24. ZhangX, Zhou M, Chen L, Hao B, Zhao G. Risk factors for preterm
birth: A case‑control study in rural area of Western China. Int J
Clin Exp Med 2015;8:4527‑32.
25. Akintayo A, Awoleke J, Ogundare E, Olatunya O, Aduloju O.
Preterm births in a resource constrained setting: Sociobiologic
risk factors and perinatal outcomes. Ghana Med J 2015;49:251‑7.
26. Morisaki N, Togoobaatar G, Vogel J, Souza J, Rowland Hogue C,
Jayaratne K, et al. Risk factors for spontaneous and providerinitiated preterm delivery in high and low human development
index countries: A secondary analysis of the World Health and
Organization multicountry survey on maternal and newborn
health. BJOG 2014;121:101‑9.
27. James DK, Steer PJ, Weiner CP, Gonik B, Robson SC. High‑Risk
Pregnancy: Management Options. United Kingdom: Cambridge
University Press; 2017.
28. Mohammadian S, Vakili M, Tabandeh A. Survey of related factors
in prematurity birth. Guilan Univ Med Sci 2000; Please provide
complete reference details such as volume and page.
29. Heaman MI, Blanchard JF, Gupton AL, Moffatt ME, Currie RF.
Risk factors for spontaneous preterm birth among Aboriginal and
non-Aboriginal women in Manitoba. Paediatr Perinatol Epidemiol
2005;19:181‑93.
30. Ratzon R, Sheiner E, Shoham‑Vardi I. The role of prenatal care
in recurrent preterm birth. Eur J Obstet Gynecol Reprod Biol
2011;154:40‑4.
31. Abu Hamad KH, Abed Y, Abu Hamad B. Risk factors associated
with preterm birth in the Gaza Strip: Hospital‑based case‑control
study. East Mediterr Health J 2007;13:1132‑41.
32. Baskaradoss JK, Geevarghese A, Kutty VR. Maternal periodontal
status and preterm delivery: A hospital based case‑control study.
J Periodontal Res 2011;46:542‑9.
33. Winer N, Resche‑Rigon M, Morin C, Ville Y, Rozenberg P. Is
induced abortion with misoprostol a risk factor for late abortion
or preterm delivery in subsequent pregnancies? Eur J Obstet
Gynecol Reprod Biol 2009;145:53‑6.
34. Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B,
Thiriez G, et al. Previous induced abortions and the risk of
very preterm delivery: Results of the EPIPAGE study. BJOG
2005;112:430‑7.
35. Behrman V. Preterm Birth: Prevention and Management.
Hoboken, New Jersey, United States: Wiley‑Blackwell; 2010.
36. Ancel PY, Lelong N, Papiernik E, Saurel‑Cubizolles MJ,
Kaminski M, EUROPOP. History of induced abortion as a risk
factor for preterm birth in European countries: Results of the
EUROPOP survey. Hum Reprod 2004;19:734‑40.
37. Al‑Dabbagh SA, Al‑Taee WY. Risk factors for pre‑term birth in
Iraq: A case‑control study. BMC Pregnancy Childbirth 2006;6:13.
38. Offiah I, O’Donoghue K, Kenny L. Clinical Risk Factors for
Preterm Birth. Preterm Birth‑Mother and Child. United Kingdom:
IntechOpen; 2012.
39. Teklay G, Teshale T, Tasew H, Mariye T, Berihu H, Zeru T.
Risk factors of preterm birth among mothers who gave birth in public hospitals of central zone, Tigray, Ethiopia: Unmatched
case‑control study 2017/2018. BMC Res Notes 2018;11:571.
40. Romero R, Espinoza J, Chaiworapongsa T, Kalache K. Infection
and prematurity and the role of preventive strategies. Semin
Neonatol 2002;7:259‑74.
41. Gonçalves LF, Chaiworapongsa T, Romero R. Intrauterine
infection and prematurity. Ment Retard Dev Disabil Res Rev
2002;8:3‑13.
42. Hammoud AO, Bujold E, Sorokin Y, Schild C, Krapp M,
Baumann P. Smoking in pregnancy revisited: Findings
from a large population‑based study. Am J Obstet Gynecol
2005;192:1856‑62.
43. Kyrklund‑Blomberg NB, Granath F, Cnattingius S. Maternal
smoking and causes of very preterm birth. Acta Obstet Gynecol
Scand 2005;84:572‑7.
44. Nabet C, Ancel PY, Burguet A, Kaminski M. Smoking during
pregnancy and preterm birth according to obstetric history:
French national perinatal surveys. Paediatr Perinat Epidemiol
2005;19:88‑96.
45. Conde‑Agudelo A, Romero R, Nicolaides K, Chaiworapongsa T,
O’Brien JM, Cetingoz E, et al. Vaginal progesterone vs. cervical
cerclage for the prevention of preterm birth in women with a
sonographic short cervix, previous preterm birth, and singleton
gestation: A systematic review and indirect comparison
metaanalysis. Am J Obstet Gynecol 2013;208:42.e1‑18.
46. Dadipoor S, Mehraban M, Ziapour A, Safari‑Moradabadi A.
Causes of maternal mortality in Iran: A systematic review. Int j
Pediatr 2017;5(12):6757‑70.
47. Been JV, Nurmatov UB, Cox B, Nawrot TS, van Schayck CP,
Sheikh A. Effect of smoke‑free legislation on perinatal and
child health: A systematic review and meta‑analysis. Lancet
2014;383:1549‑60.