1.1 Introduction
Preterm birth is defined as the delivery of a baby before 37 completed weeks of gestation and is recognized as one of the leading causes of neonatal morbidity and mortality worldwide, particularly in low and middle income countries such as Nigeria (World Health Organization, 2023). It represents a major public health challenge because babies born too early often face difficulties in breathing, feeding, regulating body temperature, and surviving the early days of life without intensive medical support (UNICEF, 2022). In Nigeria, preterm birth remains a significant contributor to infant deaths and long term developmental complications, despite ongoing maternal and child health programs aimed at improving pregnancy outcomes. The situation is worsened by a combination of medical, socioeconomic, and behavioural factors affecting mothers during pregnancy (Adewuyi et al., 2021).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Preterm birth is defined as the delivery of a baby before 37 completed weeks of gestation and remains one of the leading causes of neonatal mortality and morbidity globally, especially in low and middle income countries such as Nigeria (World Health Organization, 2023). According to the World Health Organization (WHO), an estimated 13.4 million babies are born preterm each year worldwide, and complications arising from preterm birth are responsible for nearly one million deaths annually, making it a major public health concern that requires urgent attention. In Nigeria, the burden is particularly high due to a combination of maternal, socioeconomic, and healthcare system related factors that continue to affect pregnancy outcomes.
According to UNICEF (2022), Nigeria ranks among the countries with the highest number of preterm births globally, contributing significantly to under five mortality rates. UNICEF further reported that many of these deaths are preventable if adequate maternal healthcare services, including timely antenatal care and skilled birth attendance, are made accessible and utilized effectively. The organization also emphasized that maternal health conditions before and during pregnancy play a crucial role in determining whether a baby is born preterm.
Adewuyi et al. (2021) stated that, maternal factors such as inadequate antenatal care attendance, maternal age below 18 years or above 35 years, low educational attainment, poor nutritional status, and pre existing medical conditions such as hypertension and diabetes are strongly associated with preterm birth in Nigeria. The authors reported that women who fail to attend antenatal clinics regularly are more likely to experience complications that lead to early labour because pregnancy risks are not detected and managed on time. They further asserted that infections such as malaria and urinary tract infections during pregnancy significantly increase the likelihood of preterm delivery, especially in regions where access to preventive healthcare is limited.
Fawole et al. (2020) asserted that, maternal health behaviours and environmental exposures also contribute significantly to preterm birth outcomes. The researchers stated that pregnant women who engage in heavy physical labour, experience high levels of psychological stress, or are exposed to poor environmental conditions are at increased risk of delivering prematurely. They further affirmed that domestic violence and lack of social support systems also play indirect roles in increasing maternal stress levels, which may trigger early onset of labour.
The World Bank (2022) articulated that, Nigeria's healthcare system faces significant structural challenges, including inadequate funding, shortage of skilled health professionals, and poor distribution of healthcare facilities between urban and rural areas. The report asserted that these systemic weaknesses reduce the quality of maternal healthcare services and limit early detection and management of high risk pregnancies. It also contends that financial barriers prevent many pregnant women from accessing adequate antenatal care, thereby increasing their vulnerability to complications such as preterm birth.
According to Lawn et al. (2020), preterm birth is not only a medical issue but also a developmental and economic challenge that affects families and national development. The authors reported that children born prematurely often require long term medical care and may experience cognitive and physical disabilities, which place a financial burden on households and healthcare systems. They asserted that reducing preterm birth rates is essential for achieving global sustainable development goals related to maternal and child health. This study is set against the backdrop of the increasing prevalence of preterm birth in Nigeria and the need to identify and address the maternal factors contributing to this public health challenge.
1.3 Statement of Problems
Investigation revealed that many pregnant women, particularly in rural and low-income settings, delay antenatal visits or receive inadequate care due to financial constraints, limited access to healthcare facilities, and cultural beliefs that influence health-seeking behaviour. On the other hand, maternal stress, heavy physical workload, and exposure to domestic or environmental hazards during pregnancy are also contributing factors that worsen pregnancy outcomes. In many Nigerian communities, women engage in physically demanding activities throughout pregnancy due to socioeconomic pressures, which increases the risk of preterm labour (Fawole et al., 2020).
Furthermore, rural health centres are often under-resourced, making it difficult to provide comprehensive antenatal monitoring and early detection of high-risk pregnancies. These systemic challenges interact with maternal factors to worsen the burden of preterm birth in Nigeria. It is against this backdrop that this study seeks to examine maternal factors associated with preterm birth in Nigeria.
1.4 Aim and Objectives of Study
The aim of this study is to assess maternal factors associated with preterm birth in Nigeria. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the effect of maternal age on preterm birth in Nigeria.
- To assess the relationship between antenatal care attendance and preterm birth in Nigeria.
- To examine the influence of maternal infections on preterm birth in Nigeria.
- To evaluate the effect of maternal nutritional status on preterm birth in Nigeria.
- To investigate the impact of socioeconomic status on preterm birth in Nigeria.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the effect of maternal age on preterm birth in Nigeria?
- What is the relationship between antenatal care attendance and preterm birth in Nigeria?
- What is the influence of maternal infections on preterm birth in Nigeria?
- What is the effect of maternal nutritional status on preterm birth in Nigeria?
- What is the impact of socioeconomic status on preterm birth in Nigeria?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: Maternal age does not have a significant effect on preterm birth in Nigeria.
- H1: Maternal age has a significant effect on preterm birth in Nigeria.
Hypothesis Two
- H0: Antenatal care attendance does not significantly influence preterm birth in Nigeria.
- H1: Antenatal care attendance significantly influences preterm birth in Nigeria.
Hypothesis Three
- H0: Maternal infections do not significantly affect preterm birth in Nigeria.
- H1: Maternal infections significantly affect preterm birth in Nigeria.
Hypothesis Four
- H0: Maternal nutritional status does not significantly affect preterm birth in Nigeria.
- H1: Maternal nutritional status significantly affects preterm birth in Nigeria.
Hypothesis Five
- H0: Socioeconomic status does not significantly influence preterm birth in Nigeria.
- H1: Socioeconomic status significantly influences preterm birth in Nigeria.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will assist healthcare providers in early identification of high risk pregnancies and improve maternal health interventions based on World Health Organization maternal health standards. Also, the study will assist hospitals and primary health centres in improving maternal care delivery systems.
Furthermore, the findings will assist healthcare providers in improving early detection and management of high risk pregnancies. In addition, the findings will support policymakers in designing effective maternal health programs aimed at reducing preterm birth rates in Nigeria.
Lastly, the findings will contribute to academic researchers by providing updated data on maternal determinants of preterm birth in Nigeria.
1.8 Scope and Limitations of the Study
The scope of the study covers maternal age, antenatal care attendance, maternal infections, nutritional status, and socioeconomic factors as they relate to preterm birth among pregnant women in University College Hospital, Ibadan, Oyo State.
The study is limited to selected respondents within the hospital setting and may not fully represent the entire population of pregnant women in Nigeria due to regional and healthcare access differences.
1.9 Definition of Terms
Preterm Birth:
Preterm birth is the delivery of a baby before 37 completed weeks of gestation and is a leading cause of neonatal morbidity and mortality globally (World Health Organization, 2023).
Maternal Age:
Maternal age refers to the age of a woman during pregnancy, which has been associated with pregnancy outcomes including preterm delivery (UNICEF, 2022).
Antenatal Care:
Antenatal care is the healthcare provided to pregnant women to monitor pregnancy progress and reduce risks of complications during childbirth (World Health Organization, 2023).
Maternal Infection:
Maternal infection refers to infectious diseases occurring during pregnancy such as malaria and urinary tract infections that may contribute to adverse birth outcomes (Adewuyi et al., 2021).
Socioeconomic Status:
Socioeconomic status refers to an individual's economic and social position in relation to income, education, and occupation, which influences access to healthcare services (UNICEF, 2022).
Nutritional Status:
Nutritional status refers to the condition of a pregnant woman's health as influenced by dietary intake and nutrient availability, which affects fetal development and birth outcomes (World Health Organization, 2023).
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