Prevalence and determinants of preterm birth at University Teaching Hospital of Kigali: a retrospective study

Abstract

Preterm birth, defined as delivery before 37 completed weeks of gestation, is a leading cause of neonatal illness and death worldwide, particularly in low- and middle-income countries such as Rwanda. Despite progress in maternal and newborn healthcare, preterm birth remains a major public health concern. This study aimed to determine the prevalence and determinants of preterm birth. This retrospective cross-sectional study reviewed medical records of 1,327 women who delivered at the University Teaching Hospital of Kigali between January 1 and December 31, 2024. Using total enumeration, data were collected on maternal socio-demographic characteristics, obstetric factors, and medical conditions. Descriptive statistics, bivariate analysis, and multivariable logistic regression were applied to determine the prevalence of preterm birth and its associated factors. The prevalence of preterm birth at the University Teaching Hospital of Kigali was 13.26%. Independent predictors of preterm birth included a history of preterm birth (AOR = 7.13, 95% CI: 3.08–16.49), preeclampsia (AOR = 3.02, 95% CI: 1.32–6.89), hypertension (AOR = 2.13, 95% CI: 1.04–4.35), premature rupture of membranes (AOR = 7.57, 95% CI: 4.06–14.09), and attending four or more antenatal care visits (AOR = 4.19, 95% CI: 1.84–9.56). Preterm birth remains a major public health concern in Rwanda, particularly among high-risk pregnancies referred to tertiary care centers such as the University Teaching Hospital of Kigali. These findings highlight the need for strengthening early risk detection, improving primary healthcare services, and ensuring timely referral and management of at-risk women to reduce preterm birth and its associated complications.