Evaluation of risk factors in preterm delivery and impact of education in its prevention

Preterm delivery is the major cause of morbidity and mortality (except for congenital anomalies) in the neonatal period. These neonates, who have also low birth weights, need special care with expensive handling. This research attempts to clarify the predictor factors of preterm delivery and to determine success rates of education programs in the prevention of preterm delivery. In this study, 1117 pregnant mothers who referred to maternal and childhood health units of 36 Shiraz urban health centers were divided to high risk (n=519) and low risk (n=598) groups base on their risk factors. Chi square test and logistic regression models (binary & polytomous response) were used to analyze data. The incidence rates of preterm delivery in the low and high-risk groups were 3.1 and 14.7 percent respectively. Percentages of premature and low birth weight in the low and high-risk groups were 0.7 and 6.5 respectively. The most important factors in decreasing gestational age and preterm delivery were: cervical dilatation of more than 1 cm, premature uterine contractions, multiple pregnancy and smoking (p<0.01). If the program is performed at lower gestational ages it has more significant effect on prevention of preterm delivery (p<0.005). In management of premature labor pain, instructions had significant effect if smoking, multiple pregnancy, and premature uterine contractions were present. We conclude that this preventive strategy helps to lower the incidence of preterm delivery and prenatal mortality rate. This program applied as some of maternal care in high risk pregnant women in Fars province.