Malawi Medical Journal

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Preterm birth in rural Malawi – high incidence in ultrasound-dated population

Chikondi Ntonya, Edith Kayira, S White, George Kafulafula, James P Neilson, Nynke van den Broek


Background: Preterm birth is a major cause of neonatal death, and has an incidence in industrialised countries of 7%. There are still very limited data from developing countries.

Methods: Cohort study of 512 unselected pregnant women in rural communities in Malawi. All had ultrasound foetal measurements before 24 weeks.

Results: 20.3% of women delivered before 37 completed weeks of pregnancy. Babies born before 37 completed weeks (but after 24 weeks) were more likely to die within the first 24 hours than babies born at term 21.7% vs 3.4% (risk ratio: 6.32, 95%CI 3.21,12.45).

Conclusions: This population has a very high rate of preterm birth, which is probably infection-related. It may be representative of many rural populations in sub-Saharan Africa. Tackling the problem of neonatal mortality in low income countries will require effective methods to prevent preterm birth.

Malawi Medical Journal Vol. 17(3) 2005: 85-87
AJOL African Journals Online