Background: Malawi has the highest estimated preterm birth rate in the world, estimated at
18.1%. Preterm birth represent a major, largely unrecognized, public health problem
contributing to the high rates of neonatal mortality in Malawi.
Objectives: This thesis gives an overview of the causes, prevention, treatment and
complications of preterm birth. Special emphasis is on Malawi, and a presentation of the
most relevant studies on preterm labour, conducted in Malawi, is included. With the articles
from Malawi as a basis, I will discuss what they can do in this low-income country to reduce
the rate of preterm birth.
Method: This is a literature study. The articles used for the chapters regarding causes,
prevention, treatment and complications of preterm birth, are chosen through nonsystematic
searches on Pub Med, and articles were picked out from the criteria of being of
recent date, updated and of good quality. The literature from Malawi is chosen through a
systematic search on Pub Med using the search-words “preterm” AND “Malawi”, and 25
articles were picked out.
Discussion: Studies investigating risk factors associated with preterm birth in Malawi have
identified several factors that can be modified. Focus on maternal health and nutrition in the
preconception- and antenatal period can reduce the incidence of preterm birth. Increasing
the coverage of prevention in adolescence, promoting family planning, and changing
Malawi’s guidelines for prevention of malaria in pregnancy can contribute to reduction of
the preterm birth rate.
Conclusion: Attacking risk factors found to be associated with preterm birth in Malawi, in
studies where ultrasound were used to determine gestational age, will be important if
Malawi’s preterm birth rate shall improve. Focus on pre-pregnancy- and antenatal care will
be essential.