Preterm birth and public health challenges: Incidence and risk factors.

Objective: Preterm birth is a global problem, with most preterm births occurring in low and middle-income countries like Iran. This study determined the incidence and risk factors associated with preterm birth in rural areas of sardasht, Iran.

Methods: Case-control study. Methods: A case-control study was conducted among 414 pregnant women in rural areas (138 cases and 276 controls) in Sardashat, Iran. Data were extracted from medical records. Gestational age was estimated through ultrasound during the first trimester. Statistical analyses were performed with logistic regression.

Results: Results of multivariable logistic regression analysis showed a significant association between preterm birth and the following factors: Education levels, antenatal care visits [AOR = 2.74 (95 % CI; 1.42-5.28)], maternal anemia in the first trimester [AOR = 4.92 (95 % CI; 1.30-18.71)], parity [AOR = 3.48 (95 % CI; 1.25-9.69)], premature rupture of membranes [AOR = 8.32 (95 % CI; 2.89-23.91)], gestational diabetes mellitus [AOR = 7.87 (95 % CI; 2.19-28.31)], preeclampsia [AOR = 6.14 (95 % CI; 1.74-21.7)], history of abortion [AOR = 2.69 (95 % CI; 1.23-5.90)] and maternal age.

Conclusions: Preterm birth was significantly associated with education level, antenatal care visits, premature rupture of membranes, gestational diabetes mellitus, preeclampsia, maternal anemia, parity, history of abortion and maternal age. High-risk pregnant women should receive more intensive prenatal care to prevent preterm birth.