Iranian Journal of Neonatology

Iranian Journal of Neonatology

Prevalence and Associated Factors of Premature Birth at Ramadi Teaching Hospital for Maternity and Children: A Cross-sectional Study

Document Type : Original Article

Authors
Rana F. Shitran 1
Sabah M. Ali 2
1 Department of Pediatrics, University of Anbar, Ramadi, Al Anbar, Iraq
2 Department of Pediatrics, University of Mustansiriyah, Baghdad, Iraq
10.22038/ijn.2026.78358.2522
Abstract
Background: Prematurity poses a significant health concern, and it is crucial to identify the factors associated with it in order to reduce the burden on neonatal care units and prevent associated mortality. To determine the prevalence of premature delivery and identify the associated risk factors at Alramadi Teaching Hospital for Maternity and Children.
Methods: A prospective cross-sectional study was conducted at Ramadi Teaching Hospital for Maternity and Children. The study included all live births that were at least 20 weeks into gestation, while excluding stillbirths and cases where information on gestation length was missing. Checklist was used to collect the necessary information. Logistic regression was employed to analyze the risk factors.
Results: This study involved 1327 neonates, of which 204 were preterm, resulting in a prevalence of preterm delivery of 15.4%. By using logistic regression to analyze the associated variables, the study found that mothers under the age of 25 had a significant impact with an odds ratio of 4.2. Additionally, a history of prematurity was found to be significant with an odds ratio of 5.71, multiple pregnancies were also significantly associated with an odds ratio of 7.22, and complications during pregnancy showed significance with an odds ratio of 6.41.
Conclusion: The prevalence of prematurity at Ramadi Teaching Hospital for Maternity and Children in Anbar, Iraq, is 15.4%. The most associated risk factors were identified as younger maternal age, maternal history of prematurity, multiple pregnancy, and complications during pregnancy.
 
Keywords
Neonate
Ramadi city
Risk factors
Prematurity
Prevalence
  1. Heikkilä K, Metsälä J, Pulakka A, Nilsen SM, Kivimäki M, Risnes K, et al. Preterm birth and the risk of multimorbidity in adolescence: a multiregister-based cohort study. Lancet Public Health. 2023;8(9):e680-e690.
  2. Mocking M, Adu-Bonsaffoh K, Osman KA, Tamma E, Ruiz AM, van Asperen R, et al. Causes, survival rates, and short-term outcomes of preterm births in a tertiary hospital in a low resource setting: An observational cohort study. Front Glob Womens Health. 2023;3:989020.
  3. Qassim Jawad S, AL-Rubaee EA, Ali IA. Assessment of the levels of vasopressin and androgen in the sample of Iraqi children with Autism spectrum disorder. Cell Mol Biomed Rep. 2024;4(2):111-11
  4. Alavi H, Zaheri F, Shahoei R. Support and control during childbirth and attachment after birth in mothers referring to comprehensive health centers in Bijar, 2019. Cell Mol Biomed Rep. 2023;3(1):
    17-28.
  5. Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health. 2019;7(1):e37-e46.
  6. Ohuma EO, Moller AB, Bradley E, Chakwera S, Hussain-Alkhateeb L, Lewin A, et al. National, regional, and global estimates of preterm birth in 2020, with trends from 2010: A systematic analysis. 2023;402(10409):1261-1271.
  7. Gurol-Urganci I, Jardine JE, Carroll F, Draycott T, Dunn G, Fremeaux A, et al. Maternal and perinatal outcomes of pregnant women with SARS-CoV-2 infection at the time of birth in England: National cohort study. Am J Obstet Gynecol. 2021; 225(5):522.e1-522.e11.
  8. Buffoni I, Buratti S, Mallamaci MF, Pezzato S, Lampugnani E, Buffelli F, et al. Sudden Onset of severe pulmonary hypertension in a preterm infant: A case report on the role of maternal use of serotonin re-uptake inhibitors during pregnancy and concurrent risk factors. Front Pediatr. 2022;10:855419.
  9. Miller L, Schmidt CN, Wanduru P, Wanyoro A, Santos N, Butrick E, et al. Adapting the preterm birth phenotyping framework to a low-resource, rural setting and applying it to births from Migori County in western Kenya. BMC Pregnancy Childbirth. 2023;23(1):729.
  10. Rutayisire E, Mochama M, Ntihabose CK, Utumatwishima JN, Habtu M. Maternal, obstetric and gynecological factors associated with preterm birth in Rwanda: findings from a national longitudinal study. BMC Pregnancy Childbirth. 2023;23(1):365.
  11. Alijahan R, Hazrati S, Mirzarahimi M, Pourfarzi F, Ahmadi Hadi P. Prevalence and risk factors associated with preterm birth in Ardabil, Iran. Iran J Reprod Med. 2014;12(1):47-56.
  12. Adugna DG. Prevalence and associated risk factors of preterm birth among neonates in referral hospitals of Amhara Region, Ethiopia. PLoS One. 2022;17(10):e0276793.
  13. Alamneh TS, Teshale AB, Worku MG, Tessema ZT, Yeshaw Y, Tesema GA, et al. Preterm birth and its associated factors among reproductive aged women in sub-Saharan Africa: evidence from the recent demographic and health surveys of sub-Sharan African countries. BMC Pregnancy Childbirth. 2021;21(1):770.
  14. Sendeku FW, Beyene FY, Tesfu AA, Bante SA, Azeze GG. Preterm birth and its associated factors in Ethiopia: A systematic review and meta-analysis. Afr Health Sci. 2021;21(3):1321-1333.
  15. Yaya S, Odusina EK, Adjei NK, Uthman OA. Association between intimate partner violence during pregnancy and risk of preterm birth. BMC Public Health. 2021;21(1):1610.
  16. Etil T, Opio B, Odur B, Lwanga C, Atuhaire L. Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital. BMC Pregnancy Childbirth. 2023; 23(1):814. Erratum in: BMC Pregnancy Childbirth. 2023;23(1):845.
  17. Kalengo NH, Sanga LA, Philemon RN, Obure J, Mahande MJ. Recurrence rate of preterm birth and associated factors among women who delivered at Kilimanjaro Christian Medical Centre in Northern Tanzania: A registry based cohort study. PLoS One. 2020;15(9):e0239037.
  18. Nwankwo HC, Habtu M, Rutayisire E, Kalisa R. Prevalence and factors associated with preterm birth in a rural district hospital, Rwanda. Pan Afr Med J. 2022;43:173.
  19. Abdo RA, Halil HM, Muhammed MA, Karebo MS. Magnitude of preterm birth and its associated factors: A cross-sectional study at Butajira Hospital, Southern Nations, Nationalities, and People's Region, Ethiopia. Int J Pediatr. 2020;2020:6303062.
  20. Taha Z, Ali Hassan A, Wikkeling-Scott L, Papandreou D. Factors associated with preterm birth and low birth weight in Abu Dhabi, the United Arab Emirates. Int J Environ Res Public Health. 2020;17(4):1382.
  21. Alberton M, Rosa VM, Iser BPM. Prevalence and temporal trend of prematurity in Brazil before and during the COVID-19 pandemic: a historical time series analysis, 2011-2021. Epidemiol Serv Saude. 2023;32(2):e2022603.
  22. Berhane M, Workineh N, Girma T, Lim R, Lee KJ, Nguyen CD, et al. Prevalence of low birth weight and prematurity and associated factors in neonates in Ethiopia: Results from a hospital-based observational study. Ethiop J Health Sci. 2019; 29(6):677-688.
  23. Ghelichkhani S, Masoumi SZ, Shirzadeh AA, Khazaei S, Shahbazi F. Evaluation of maternal risk factors for preterm delivery in Fatemieh Hospital of Hamadan, Iran, 2019: A case-control study. J Family Med Prim Care. 2021;10(10):3832-3837.
  24. Al Shareef Z, Al-Shahrabi R, Saheb Sharif-Askari F, AlDhmanie A, Alshamsi Y, Zarooni AA, et al. Incidence and risk factors of prostate cancer among the Northern and Eastern parts of the United Arab Emirates population. Prostate. 2024;84(2):185-192.
  25. Taha Z, Hassan AA, Papandreou D. Epidemiology of pre-pregnancy body mass index (BMI) among mothers in Abu Dhabi, the United Arab Emirates. Front Glob Womens Health. 2022;3:893808.
  26. Rugumisa BT, Bongcam-Rudloff E, Lukumay MS, Lyantagaye SL. Factors associated with risk of preterm delivery in Tanzania: A case-control study at Muhimbili National Hospital. Int J Gynaecol Obstet. 2021;154(2):318-323.
  27. Teklay G, Teshale T, Tasew H, Mariye T, Berihu H, Zeru T. Risk factors of preterm birth among mothers who gave birth in public hospitals of central zone, Tigray, Ethiopia: unmatched case-control study 2017/2018. BMC Res Notes. 2018;11(1):571.
  28. Tingleff T, Räisänen S, Vikanes Å, Sandvik L, Sugulle M, Murzakanova G, et al. Different pathways for preterm birth between singleton and twin pregnancies: a population-based registry study of 481 176 nulliparous women. BJOG. 2023; 130(4):387-395.
  29. Gejo NG, W/Mariam MT, Kebede BA, Abdo RA, Anshebo AA, Halil HM, et al. Factors associated with preterm birth at Wachemo University Nigist Eleni Mohammed memorial hospital, southern Ethiopia: case-control study. BMC Pregnancy Childbirth. 2021;21(1):35.
  30. Ayele TB, Moyehodie YA. Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia. BMC Pregnancy Childbirth. 2023; 23(1):204.
  31. Lu L, Qu Y, Tang J, Chen D, Mu D. Risk factors associated with late preterm births in the underdeveloped region of China: A cohort study and systematic review. Taiwan J Obstet Gynecol. 2015;54(6):647-53. 
  32. Behrman RE, Butler AS. Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes; Behrman RE, Butler AS, editors. Preterm Birth: Causes, Consequences, and Prevention. Washington (DC): National Academies Press (US); 2007. 4, Sociodemographic and Community Factors Contributing to Preterm Birth. Available from: https://www.ncbi.nlm.nih.gov/books/NBK11388/ 2007
  33. McManemy J, Cooke E, Amon E, Leet T. Recurrence risk for preterm delivery. Am J Obstet Gynecol. 2007;196(6):576.e1-6; discussion 576.e6-7.
  34. Chauhan SP, Scardo JA, Hayes E, Abuhamad AZ, Berghella V. Twins: prevalence, problems, and preterm births. Am J Obstet Gynecol. 2010; 203(4):305-315.

 

 

Iranian Journal of Neonatology
Volume 17, Issue 2
Spring 2026
Pages 21-28