Risk discriminators related to the incidence of preterm labor or delivery

Preterm delivery is a major contributor to infant morbidity and mortality in the United States. Unfortunately, the incidence of delivery prior to 37 weeks gestation has remained unchanged for the past five to ten years in Tennessee. Risk assessment, preterm labor prevention programs and early intervention have not been successful in reducing the 16% incidence of preterm deliveries as reported by the Tennessee Perinatal Data Center. The purpose of this descriptive study was to investigate selected risk factors such as smoking, sexual practices, infection, anemia, perceived stress, reported social support and stated desire for the pregnancy and their correlation to the incidence of preterm labor and delivery. Roy's Adaptation Model provided the theoretical framework for the study. A non-probability convenience sample was used. Subjects were women who agreed to participate and in the final analysis continued to meet inclusion criteria. Of the 100 subjects, 14 were excluded due to pregnancy complications, fetal anomaly, or other factors; 20% of the final sample experienced preterm labor. Subjects were recruited from four area health departments and the University of Tennessee Medical Center at Knoxville prenatal clinics. Data collection was conducted over a seven month period and utilized interviews and questionnaire completion. Instruments included the following: Problem Oriented Prenatal Risk Assessment System (POPRAS), Cohen et al.'s Perceived Stress Scale (PSS) and a questionnaire developed by the researcher. Measures of central tendency and frequency distribution were employed to describe characteristics of the sample. Categorical variables were analyzed using frequency distribution. Correlational analysis was used to test the hypotheses. An Alpha level of p < .05 was selected as the level of statistical significance. There was a significant relationship between urogenital infection and incidence of preterm labor. However, other hypothesized relationships were not supported by the data. Recommendations for nursing practice and future research were offered.