Determinants of preterm birth among newborns delivered at public referral hospitals in Bahir Dar City, Northwest Ethiopia, 2024

Abstract

BACKGROUND: Preterm birth, defined as any birth occurring before 37 completed weeks of gestation, remains a significant global health concern and is a leading cause of neonatal morbidity and mortality in Ethiopia. While previous studies have highlighted maternal age, antenatal care attendance, and birth spacing as major determinants, this study focuses on exploring less examined factors specifically maternal behavioral patterns and nutritional status among mothers delivering at Bahir Dar Public Referral Hospitals. OBJECTIVE: This study aimed to identify the determinants of preterm birth among newborns delivered at public referral hospitals in Bahir Dar City, Northwest Ethiopia, in 2024. METHODS: Institution-based unmatched case-control study was conducted using a sample of 321 participants at public referral hospitals in Bahir Dar City from September 1st to December 30th, 2024. Newborns delivered before 37 weeks of gestation were cases and two newborns delivered at 37 and above weeks at the time that each case occurred were controls by using a systematic sampling technique. Data were analyzed using both bivariable and multivariable binary logistic regression models. All variables with a p-value of less than 0.20 in the bivariable analysis were included in the multivariable regression; statistical significance was set at p < 0.05. RESULTS: A total of 107 cases and 214 controls participated with a response rate of 100%. Five determinants of preterm birth were found to be major ones. Newborns from urban residence (AOR: 0.21, 95% CI: 0.07, 0.60, p-value, 0.003) was a protective factors of preterm birth. Conversely, a large family size size six or more (AOR: 29, 95% CI: 6.29, 140.51, p-value, < 0 0.001), women with a birth interval of less than two years between consecutive births (AOR: 17, 95% CI: 4.77, 65.91, p-value, < 0.001), women who had no antenatal care (ANC) follow-up (AOR: 5, 95% CI: 1.68, 14.77, p-value, 0.004), and women who did not take iron with folic acid during pregnancy (AOR: 5, 95% CI: 1.69, 18.29, p-value, 0.005) were risk factors associated with preterm births. CONCLUSION AND RECOMMENDATIONS: The protective factor was urban residence while the number of family members 6 and above, less than 2 years of the intervals between births, lack of ANC follow-up, and lack of iron with folic acid supplementation were significant risk factors with preterm birth. The regional health bureau should reduce the gap between urban and rural health disparities, increase ANC coverage, reduce determinant risk factors, and enhance protective factors of preterm birth to improve maternal and neonatal health outcomes.