J Prev Med Public Health.  2016 May;49(3):165-175. 10.3961/jpmph.16.022.

Risk Factors for Preterm Birth and Low Birth Weight Among Pregnant Indian Women: A Hospital-based Prospective Study

• Tellapragada C
• Eshwara VK
• Bhat P
• Acharya S
• Kamath A
• Bhat S
• Rao C
• Nayak S
• Mukhopadhyay C

• KMID: 2308882
• DOI: http://doi.org/10.3961/jpmph.16.022

Abstract

OBJECTIVES
The present study was undertaken to study the maternal risk factors for preterm birth (PTB) and low birth weight (LBW) with a special emphasis on assessing the proportions of maternal genitourinary and periodontal infections among Indian women and their association with adverse pregnancy outcomes.
METHODS
A hospital-based prospective study comprising 790 pregnant women visiting the obstetrics clinic for a routine antenatal check-up was undertaken. Once recruited, all study participants underwent clinical and microbiological investigations for genitourinary infections followed by a dental check-up for the presence of periodontitis. The study participants were followed up until their delivery to record the pregnancy outcomes. Infectious and non-infectious risk factors for PTB and LBW were assessed using univariate and multivariate Cox regression analysis. Independent risk factors for PTB and LBW were reported in terms of adjusted relative risk (ARR) with the 95% confidence interval (CI).
RESULTS
Rates of PTB and LBW in the study population were 7.6% and 11.4%, respectively. Previous preterm delivery (ARR, 5.37; 95% CI, 1.5 to 19.1), periodontitis (ARR, 2.39; 95% CI, 1.1 to 4.9), Oligohydramnios (ARR, 5.23; 95% CI, 2.4 to 11.5), presence of Nugent's intermediate vaginal flora (ARR, 2.75; 95% CI, 1.4 to 5.1), gestational diabetes mellitus (ARR, 2.91; 95% CI, 1.0 to 8.3), and maternal height <1.50 m (ARR, 2.21; 95% CI, 1.1 to 4.1) were risk factors for PTB, while periodontitis (ARR, 3.38; 95% CI, 1.6 to 6.9), gestational hypertension (ARR, 3.70; 95% CI, 1.3 to 10.8), maternal height <1.50 m (ARR, 2.66; 95% CI, 1.3 to 5.1) and genital infection during later stages of pregnancy (ARR, 2.79; 95% CI, 1.2 to 6.1) were independent risk factors for LBW.
CONCLUSIONS
Our study findings underscore the need to consider screening for potential genitourinary and periodontal infections during routine antenatal care in developing countries.

Keyword

Bacteriuria; Bacterial vaginosis; Intermediate vaginal flora; Low birth weight; Periodontitis; Premature birth

MeSH Terms

Bacteriuria
Developing Countries
Diabetes, Gestational
Female
Humans
Hypertension, Pregnancy-Induced
Infant, Low Birth Weight*
Infant, Newborn
Mass Screening
Obstetrics
Oligohydramnios
Periodontitis
Pregnancy
Pregnancy Outcome
Pregnant Women
Premature Birth*
Prospective Studies*
Risk Factors*
Vaginosis, Bacterial