Assesment of maternal and fetal results of preterm births in our clinic over A five year period

Preterm birth is defined as the birth which occurs between the limit of viability and the 37 weeks or 259 days of gestation. Preterm birth is a major cause of perinatal morbidity and mortality. In this study, the clinical data of 649 women (out of 5,613) who had preterm birth between September 2010 and August 2014 at Dicle University Medical School Gynecology and Obstetrics Department and the first neonatal hour of their babies were investigated. The women who had a history of caesarean birth and no additional obstetric problems were excluded from the study. Patient data were retrieved from the electronic databases. The ages of the patients included 25 (3.85%), <18 years; 471 (72.57%), 19-34 years; and 153, (23.57%) >35 years (range, 14-48 years). Numbers of previous births were as follows: none, 99 (15.3%); once, 95 (14.6%); twice, 89 (13.7%); three times, 44 (6.8%), four times, 45 (6.9%) and five times or more, 73 (11.2%). Overall preterm birth rate was 11.56%. Most of the births were resulted from maternal-fetal problems (50.9%), followed by preterm labor (25.4%) and preterm labor + preterm premature rupture of membranes (PPROM) (23.7%). Also, hypertensive disease (23.7%) constituted the majority of the maternal-fetal problems. The analysis on the week of delivery and the first neonatal hours revealed that the decrease in the gestational period was correlated with an increase in the duration of neonatal stay in neonatal intensive care unit (p<0.000), duration of neonatal intubation in neonatal intensive care unit (p<0.000), duration of neonatal stay in neonatal intensive care unit due to respiratory distress syndrome (p<0.0001), and neonatal mortality (p<0.001). No significant correlation was found between the causes of preterm birth and antenatal hospitalization periods and no significant difference was detected between the diabetic and non-diabetic babies in terms of neonatal stay in neonatal intensive care unit. However, a significant correlation was established between the causes of preterm birth and postnatal stay in neonatal intensive care unit (p<0.000). The birth rate for the caesarean births in the pregnancies with preeclampsia, eclampsia, and HELLP syndrome and the complicated pregnancies was 85.7%. The patients who underwent antenatal steroid had longer periods of stay in neonatal intensive care unit. Preterm birth remains a major cause of fetal morbidity and mortality. Therefore, it is crucially important that these patients should be timely diagnosed and their risk factors should be investigated. Moreover, the morbidity and mortality rates can be reduced if the neonatal babies are followed up and treated in the centers with sophisticated neonatal intensive care conditions. Key words: preterm birth, preterm labor, fetal morbidity, mortality