Premature Birth and Peripartal Outcome

The World Health Organization defines premature birth as a birth that occurs ≥22- 37weeks based on gestational age, or less than 259 days from the first day of the last menstrual cycle. 8-10% of pregnancies result in premature birth. Premature newborns are at risk of Respiratory distress syndrome(RDS), Intracranial Haemorrhage (HIC), Necrotizing enterocolitis (NEC), as well as other renal and neurologic complications. 10% of premature newborns remain handicapped throughout growth, have neurologic disorders, defects in sight and hearing, mental retardation, emotional disorders with social maladaptation as well as slowed intellectual development.Premature birth is a global problem which occurs even in Kosovo. Despite all the treatments premature birth cannot be prevented but only managed. In Kosovo, every year around 2500 births are premature, whereas the survival of the newborns is dependent on the gestational age. Therefore, births before 32 weeks and especially before 28 weeks are more challenging. The Aim.The aim of this study is to investigate premature births in the Obstetrics and Gynecology Clinic in Prishtina. This is a retrospective study in which we have analyzed the peripartal outcome based on maternal and fetal parameters. Material and Methods.This is a retrospective, descriptive, and analytic study of cases with premature births in the Obstetrics and Gynecology Clinic in Prishtina between January 2019 and March 2019. Data has been collected from medical records and evidence in the departament of delivery and operative ward. Cases with premature births have been analyzed according to maternal and fetal parameters. Maternal parameters that we have analyzed are the age, parity, mode of delivery whereas newbon parameters that were analyzed included gestational age, mode of delivery, weight at birth and vitality in the first and fifth minute according to the APGAR score.Excluding criteria: Term birthsResults:In this study, the rate of preterm birth is found to be 9.03%. Preterm birth rate was highest among women in group age between 30-40 (51%), followed by women ages 20-30 (38%), ages 40 years and older (7%) and women under age 20 (4%). Specific prematurity rate was the highest for women 40 and older (16.86%) followed by women under age 20 (12.69%). The highest proportion of premature birth was observed among primiparous women (42%) whereas women in their fourth and more pregnancy had lowest proportion (12%). The proportion of premature birth was 28 % in second pregnancy and 18% in third pregnancy. The highest rate of specific prematurity (10.41) was observed among women in their fourth and more pregnancy followed by nulliparous women (10.20%). Based on the gestational age 12.31% of cases were between 22-28 gestational weeks, 9.7% were between 28-32, 17.24% were between 32-34 and the majority respectively 60.59 were between 34-37 gestational weeks. Cesarean delivery was performed in 59% of the cases compared to vaginal birth which represented 41%. According to newborns weight at birth ,12% were between 500-1000 grams, 9% weighing between 1000-1500 and 17 % between 1500-2000 grams. 31% of premature infants were with birth weight 2000-2500 grams and 31% ≥2500 grams. There were 4% stillbirths, whereas 11% had severe asphyxia and 16% moderate asphyxia.Conclusion Based on our results, premature birth is still a problem due to unfavorable peripartum outcome.Thus, we highly recommend to increase the awareness among women regarding the importance of regular antenatal visits in order to identify women at risk for preterm birth as early as possible and to manage these cases according to the recommendations of the EPC program. since clinical efforts focus mainly on problem-solving rather than prevention