Preterm birth determinants among newborns at six public hospitals in Northeast Amhara, Ethiopia: unmatched case-control study

Abstract

<title>Abstract</title> Background Preterm birth is a global public health problem. Worldwide, every year about 15 million newborns are born preterm and about 1.1 million of them die due to complications related to prematurity. More than 81% of preterm births were in Asia and Sub-Saharan Africa. Nowadays, preterm birth is the first leading cause of under-five mortality and is one of the limiting factors for achieving a reduction in under-five mortality rate. Therefore, the aim of this study was to identify the determinants of preterm birth at public hospitals in the Northeast Amhara, Ethiopia, 2019. Method Hospital-based unmatched case-control study was conducted at public hospitals in Northeast Amhara, Ethiopia from March 15 th to April 25 th , 2019. Data were collected using interviewer-administered structured pre-tested tool and document review for cases and controls. Data were entered in to Epi Info version 7.2.2.6 and exported to SPSS version 23 software for data analysis. Bi-variable and multivariable binary logistic regression were used to measure the association between preterm birth and risk factors. Adjusted Odds ratio (AOR) at 95% confidence interval (CI) was calculated and P value ≤0.05 declared statistically significant. Result The study identified that ANC follow up less than four visits [AOR 2.267, Cl (1.205, 4.264)], pregnancy-induced hypertension [AOR 4.453, Cl (1.276, 15.536)], no iron/folic acid supplementation during pregnancy [AOR 4.175, Cl (1.632, 10.680)], anemia during pregnancy [AOR 4.776, Cl (1.492, 15.285)], and birth defect [AOR 6.160, Cl (l.896, 20.013)] were significantly associated determinants of preterm birth. Conclusion Antenatal care follow up fewer than four visits, pregnancy induced hypertension, no iron/folic acid supplementation during pregnancy, being anemic during pregnancy, and birth defect were important determinants of preterm birth.