Predictors of preterm birth and the available services in major maternal facilities in the Gambia: a qualitative study

Abstract Background: Being born before 37 weeks of gestational age or before 259 days from the first day of a woman’s last menstrual period is defined as preterm birth, according to the WHO. Being born too early is now the leading cause of death in children younger than five years worldwide. This study will determine the predictors of preterm birth and the available services designed to rehabilitate the preterm outcomes at a maternal hospital in The Gambia. Objective: To identify the predictors of preterm birth and to find out the available services in major maternal facilities in The Gambia. Materials and Methods: A qualitative study design was used, and in-depth interviews with the key informants were undertaken to identify the predictors of preterm birth and determine the available services designed to rehabilitate preterm outcomes. Results: The data support the theory that the analysis identifies pre-eclampsia, history of previous preterm delivery, premature rupture of membrane, late antenatal booking, a birth interval of fewer than two years, birth to twins, history of bleeding during pregnancy, urinary tract infection during pregnancy, gestational diabetes, advance maternal age, caesarian section mode of delivery as the key risk factors of preterm birth among women who delivered in the BMCHH during the study period. The data also suggests that interventions like family planning, early and regular antenatal visits, immediate breastfeeding of the baby, and cord care are significant approaches in reducing the burden of preterm birth. Conclusion: Preterm birth among women delivering in BMCHH in the Gambia is a significant problem. Pre-eclampsia, preterm premature rupture of the membrane, history of preterm birth, advanced maternal age, birth to twins, late antenatal booking, urinary tract infection, bleeding during pregnancy, and interpregnancy interval are the major predictors of preterm birth. According to the study, pre-eclampsia is the major predictor of preterm birth. Prompt identification of all risk factors associated with preterm birth will help policy makers to apply immediate and appropriate specific interventions. Early and regular antenatal care and family planning offered as a package of interventions could substantially reduce the incidence and complications related to PTB and will subsequently increase the likelihood of newborn survival. All these interventions put together will increase the survival rate of preterm neonate especially in low resource settings, such as the Gambia.