SUMMARY OBJECTIVE: To determine the singleton preterm birth rate, the relative proportions of the clinical categories of preterm births and to compare the outcomes in these categories. SETTING: Department of Obstetrics & Gynaecology, Korle Bu Teaching Hospital. PARTICIPANTS: Preterm births from 1(st) July to 31(st) December 2003. RESULTS: Out of a total of 4731 singleton births 440 were preterm, giving a preterm birth rate of 9.3%. One hundred and eighty-five (42%, [95% Confidence Interval (CI) 37.4%, 46.8%]) preterm births followed spontaneous onset of preterm labour (group A), 82 (18.6%, [95% CI 15.2%, 22.7%]) followed preterm premature rupture of membranes, PPROM (group B) and 173 (39.3%, [95% CI 34.8%, 44.1%]) were medically indicated (group C). The commonest indication for delivery in group C was severe pre-eclampsia/eclampsia. Although there was no significant difference in the mean gestational ages at delivery between the groups, babies in group C had significantly lower birth weights. No differences in sex ratios, still-birth rates, or incidence of low Apgar scores were found. Babies in group C were significantly more likely to be admitted to the neonatal intensive care unit (NICU) and had a significantly higher perinatal death rate. Survivors of NICU admission among group C babies spent significantly longer periods in hospital before discharge. CONCLUSION: Outcomes of preterm births in Korle Bu Teaching Hospital are less favourable among indicated preterm births than among spontaneous or PPROM-related preterm births. A detailed study of the causes of neonatal morbidity and mortality is suggested to determine any differences between the three groups.
SUMMARY OBJECTIVE: To determine the singleton preterm birth rate, the relative proportions of the clinical categories of preterm births and to compare the outcomes in these categories. SETTING: Department of Obstetrics & Gynaecology, Korle Bu Teaching Hospital. PARTICIPANTS: Preterm births from 1(st) July to 31(st) December 2003. RESULTS: Out of a total of 4731 singleton births 440 were preterm, giving a preterm birth rate of 9.3%. One hundred and eighty-five (42%, [95% Confidence Interval (CI) 37.4%, 46.8%]) preterm births followed spontaneous onset of preterm labour (group A), 82 (18.6%, [95% CI 15.2%, 22.7%]) followed preterm premature rupture of membranes, PPROM (group B) and 173 (39.3%, [95% CI 34.8%, 44.1%]) were medically indicated (group C). The commonest indication for delivery in group C was severe pre-eclampsia/eclampsia. Although there was no significant difference in the mean gestational ages at delivery between the groups, babies in group C had significantly lower birth weights. No differences in sex ratios, still-birth rates, or incidence of low Apgar scores were found. Babies in group C were significantly more likely to be admitted to the neonatal intensive care unit (NICU) and had a significantly higher perinatal death rate. Survivors of NICU admission among group C babies spent significantly longer periods in hospital before discharge. CONCLUSION: Outcomes of preterm births in Korle Bu Teaching Hospital are less favourable among indicated preterm births than among spontaneous or PPROM-related preterm births. A detailed study of the causes of neonatal morbidity and mortality is suggested to determine any differences between the three groups.
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