ABSTRACT

Background: Pre-term birth is a major challenge for maternal and perinatal care worldwide and a leading cause of neonatal morbidity and mortality. Children born prematurely have higher rate of motor disabilities, cerebral palsy, sensory deficits and respiratory illnesses compared to children born at term. These negative health and developmental effects of premature birth often extend to later life, resulting in enormous medical, educational, psychological, and social cost. The main objectives of this study was to asses pregnant women’s knowledge on the cause, prevention & consequences of pre-term birth at the Buea regional hospital (Cameroon).

Method: A descriptive cross sectional hospital base design using quantitative methods for data collection was used and data was collected using a pretested semi-structure questionnaire addressed to 73 conveniently sampled pregnant women attending antenatal clinic at the Buea Regional Hospital. Data was analysed using Microsoft Excel 2013 and presented on tables and figures in frequencies and percentages.

Results: Of the 73 participant 34 (46.6%) were aged between 21-30years old while 41(56.2%) had been pregnant 3-5 times. With regards to the cause of preterm birth, 44(60.3%) said history of preterm birth was a risk factor while 55(75.3%) said multiple pregnancy (twins, triplet) can cause preterm birth. With regards to their knowledge on the prevention of preterm birth, 57(74%) of the participant said early and regular antenatal clinic help prevent preterm birth, while 55(75.3%) said early diagnosis and treatment of infection help in the preventing preterm birth, With regards to the consequences of preterm birth 40(54.8%) said babies born premature are at high risk of being infected while 43(59%) said mothers who give birth to premature are at high risk of bleeding after delivery.

Conclusion: The study revealed that the majority of the women had good knowledge on the cause/risk factors and prevention of preterm birth, but had poor knowledge on the consequences of preterm birth to the mother and also the percentage of pregnant women that did not have adequate knowledge expressed the need for them to be educated. Base on the findings recommendation such as health facilities should encourage pregnant women to attend antenatal clinic, charts and posters should be place in the hospital showing the disadvantage of premature birth and possible consequence were made.

CHAPTER ONE

GENERAL INTRODUCTION

INTRODUCTION

Pre-term birth is a major challenge for maternal and perinatal care worldwide and a leading cause of neonatal morbidity and mortality (Koum et al., 2014). Children born prematurely have higher rate of motor disabilities, cerebral palsy, sensory deficits and respiratory illnesses compared to children born at term. These negative health and developmental effects of premature birth often extend to later life, resulting in enormous medical, educational, psychological, and social cost (Essono, 2011), until recently, there is little recognition of Pre-term birth as a worldwide problem, and this has impeded the development of policies and problems appropriate for implementations in the Low-and Middle-Income Countries (LMIC). Widely held perception that effective care of the problem of the babies requires costly intervention well beyond the health budgets of most LMICs, coupled with concerns that greater attention to premature birth will draw needed funding away from other devastating maternal and perinatal health problems, have also contributed to the reluctance of the policy makers to make the problem of premature delivery a global priority (Koum et al., 2014).

In Cameroon, Pre-term births still present a major public health problem with a prevalence rate of 26.5% (Chiabi et al., 2013). Premature birth in Cameroon is an increasingly common complex condition with multiple causes (Allen et al., 2008) and has substantial medical, psychological, economic and social impacts. Additionally, premature birth and low birth weight is associated with cardiovascular diseases in adult life (Barker et al., 2011).

Pre-term birth is an increasingly common complex condition with multiple causes and has substantial medical, psychological, economic and social impacts (Allen, 2008). It is the leading cause of infant mortality in Cameroon. Compared with term neonates, mortality rates for premature (less than 37 weeks) and very premature infants (less than 32 weeks) are 15-fold and 75-fold higher respectively (Mathews et al., 2004). The organs most commonly affected by Pre-term delivery are the lungs, as the lungs are one of the last organs to develop in uterus. Pre-term birth is also the most important determinant of short and long term morbidity in infants and children, and can have serious long term health consequences, such as cerebral palsy, blindness, and developmental difficulties, including cognitive, sensory, learning and language deficits (Allen, 2008). The younger the gestation, the greater the risk of severe morbidity. The Epipage study group reported a twofold increased prevalence of hyperactivity, inattention, and peer problems in very Pre-term birth children at school ages when compared to children born at term (Delobel-Ayoub, 2009) Additionally Pre-term birth and low birth weight is associated with cardiovascular disease in adult life (Barker et al., 2013).

1.1 BACKGROUND OF THE STUDY

Pre-term birth is defined by the birth of a baby before term that is, children born before fetal maturity, period before the 37th weeks of gestation whether spontaneous or provoked (Monebenimp. 2011). As a primary cause of neonatal death, premature birth presents a major public health problem, with an estimated 15 million premature births (11% of all births worldwide) (Liu, 2012), In developing countries, the rate of prematurity is high, but few studies on the risk factors and circumstances of prematurity have been conducted.

Approximately 90% of premature births are concentrated in developing countries, with a prevalence of 26.5% (Chiabi et al., 2013), Very few studies sought to determine the prevalence and causes of premature births. Worldwide an estimated 11.1% of all live births in 2010 were born preterm. Direct preterm birth complications accounts for one million deaths each year and premature birth had been the cause for over 50% of neonatal deaths. Babies’ born prematurely are more likely to die during the first four weeks of their lives than babies born at term (Katz et al.,2013). Data on preterm, birth rates are not routinely collected in many countries.

Although prematurity is a global burden, there are significant disparities between regions and countries. The risk of dying from premature birth complications is 10 times greater for babies born too soon in low income counties than for those born in high income countries (Blencowe  et al., 2013). While spontaneous premature births are more frequent in low income countries, provider initiated premature births are more frequent in high income countries. (Gyami-Bannerman, 2011)

In. Cameroon, premature births still present major public health problem with a prevalence of 26.5% (Chiabi et al., 2013) The Buea Regional Hospital is not exempted where the number of premature births has been on the increase as can be seen by the high number of premature babies in the neonatal unit of their health Centre