FACTORS CONTRIBUTING TO PREMATURE DELIVERY IN MOTHERS WITH MULTIPLE GESTATION AT KISUMU COUNTY REFERAL HOSPITAL

Abstract

Premature delivery, particularly in cases of multiple gestation, is a major public health issue, contributing significantly to neonatal morbidity and mortality globally. The World Health Organization estimates that in 2020 alone, 13.4 million babies were born prematurely, with multiple gestations being a key risk factor. In Kenya, the rate of preterm births, especially among mothers carrying multiple fetuses, has continued to rise despite advancements in obstetric care. This study aimed to identify the factors contributing to premature delivery in mothers with multiple gestations at Kisumu County Referral Hospital (KCRH). A cross-sectional descriptive study was conducted among 45 mothers of multiple gestation pregnancies, who experienced premature deliveries before 37 weeks of gestation. Data were collected through structured interviews, medical record reviews, and focus group discussions. The key variables examined included maternal medical conditions, placental disorders, and fetal factors, all of which were analyzed to determine their role in preterm births. The study revealed that maternal conditions such as hypertension (26.7%) and diabetes (22.2%) were significant contributors to premature delivery. Other factors included a history of miscarriage (33.3%) and HIV infection (17.8%), both of which increased the risk of preterm labor. Furthermore, placental disorders, such as premature rupture of membranes (40%) and placental abruption, were found to play a critical role. Fetal factors like twin-to-twin transfusion syndrome and intrauterine growth restrictions were also significant contributors to early labor. The findings underscore the need for enhanced antenatal care services, particularly for high-risk pregnancies such as those involving multiple gestations. Regular monitoring through ultrasound, management of maternal conditions such as hypertension and diabetes, and timely medical interventions were identified as critical measures in reducing the incidence of premature delivery. This study offers vital insights that can guide healthcare providers and policymakers in formulating strategies aimed at improving neonatal and maternal outcomes, particularly in resource-limited settings such as Kisumu County.