Abstract:

Background: Preterm birth (PTB) is a global problem with prevalence ranging from 5 to 18% leading to prematurity which further leads to increased mortality, morbidity and long-term health outcomes. Studies have shown that worldwide 20 to 30 percent of preterm babies are mandated due to maternal or fetal conditions that jeopardize the health of either the mother or fetus.
More than 60% of the world’s preterm babies and over 80% of the world’s neonatal deaths annually are due to complications related to PTB and are from sub-Saharan Africa (SSA) and Asia.

Objective: To determine the prevalence, indications and immediate perinatal outcomes of mandated preterm birth, at three selected referral Centres, Mwanza- Tanzania.

Methodology: This was a cross-sectional study, involving women delivered at gestational age less than 37weeks at three selected referral Centres in Mwanza. Data were collected using questionnaire, double entered using Epi-info, cleaned, and analyzed using STATA version 15.

Results: A total of 2230 women delivered during the study period, in which 402 delivered preterm babies where among them 246 were mandated and 156 were spontaneous preterm birth. The prevalence of mandated pre-term birth among all preterm deliveries were 61.2%. The indication for mandated preterm birth were Hypertensive disorders of pregnancy (48.4%), the preterm premature rupture of membrane (35.4%), antepartum hemorrhage (13.8%) and others were 2.4%.
Perinatal mortality up to the first 48 hours of life were 16.2% and factors associated with perinatal mortality include very long birth weight and the low Apgar score of <7 at the 5th minutes.

Conclusion and recommendations: The prevalence of mandated preterm birth was found to be (61.2%) and the leading indication were hypertensive disorders of pregnancy. We recommend early hypertension management to prevent severe forms hence will prevent or reduce mandated premature deliveries.