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Prevalence, Risk Factors and Outcome of Preterm Births at University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria: 
A 2-year Case-Control Study

Background: Preterm birth (PTB) is an important cause of perinatal morbidity and mortality in developing societies like Nigeria. It poses huge long-term medical and financial burdens for the affected children, their families, the health care system and society at large.
Objective: The objective of this study was to determine the prevalence, risk factors and birth outcome of PTB at UMTH, Nigeria.
Methodology: A two-year case-control study of cases of preterm births at the UMTH, from 1st January, 2016 to 31st December, 2017 was undertaken. For each PTB, the next term delivery was taken as control. Information on socio-demographic characteristics, risk factors, gestational ages at presentation and delivery, and birth outcome were obtained from the women’s case files with proforma and compared with that of the control. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) software Version 23. The statistical significance was set at P<0.05.
Results: During the period under review, there were 6,171 deliveries and preterm births constituted 291 births giving a prevalence rate of 4.7% or 47 per 1000 deliveries. The mean ages for the cases and controls were similar 26.4± 6.1 vs 26.5± 5.3 with (F=0.15, P=0.7) while the mean parity were 3.0±2.6 and 3.2±2.5 with (F=4.6, P=0.03). Nulliparity was commoner among the cases 61(24.6%) compared to the controls 34(13..7%) with X2 = 9.69, P=0.001. Similarly, 96(38.7%) of the cases were unbooked compared to 44(17.7%) among the conrols X2 = 26.9, P=0.000. About 20% of the cases had no formal education compared to 13% of the control. Preterm birth was associated with unbooking status (OR=1.82, CI: 1.40-2.36), nulliparity (OR = 2.05, CI: 1.29-3.26), previous preterm delivery (OR = 95.2, CI: 13.10-691.99) and pregnancy induced hypertension (OR = 25.45, CI: 9.13-70.92). Antepartum haemorrhage (OR = 13.89, CI: 4.92-39.25), twin gestation (OR = 18.18, CI: 2.40-137.68), Polyhydramnios (OR = 2.02, CI: 1.85-2.22) and PROM (OR = 5.39, CI: 2.87-10.15) were other risk factors independently associated with PTB. The perinatal mortality in PTB was 43(16.2%).
Conclusion: The prevalence rate of PTB at the UMTH is 4.7% and is associated with previous PTB, unbooked status, twin gestation, polyhydramnious, APH and PIH. Efforts should be intensified on educating women of reproductive age group on the benefits of antenatal booking in pregnancy and quality antenatal care as this would provide ample opportunity for early detection and proper management of women at risk.

Keywords: Preterm birth, Risk factors, Neonatal outcome, Maiduguri.