Factors Associated with Preterm Birth Among Pregnant Women at Sisaket Hospital

Abstract

Background: Sisaket Province reported consistently high rates of preterm births from 2022 to 2024.
Objective: To investigate the factors influencing preterm birth in pregnant women at Sisaket hospital.
Methods: This retrospective case-control study used medical records of pregnant women who received services at the delivery room of Sisaket Hospital from October 2021 to September 2023. A total of 315 pregnant women were included, with 142 in the preterm birth group and 173 in the full-term birth group. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to analyze general information. Univariable and multivariable logistic regression analyses were conducted to identify factors influencing preterm birth, with odds ratios and 95% confidence intervals calculated. Statistical significance was set at P-value of < 0.05.
Results: The study found several factors significantly associated with preterm birth. Twin pregnancies increased the risk of preterm birth by 9.47 times (95% CI: 1.20-74.86). Gestational diabetes mellitus (insulin) increased the risk by 49.09 times (95% CI: 3.76-640.13). A history of preterm birth increased the risk by 8.46 times (95% CI: 1.03-69.75), and premature rupture of membranes increased the risk by 4.66 times (95% CI: 2.20-9.90). Conversely, factors that reduced the risk of preterm birth included an interpregnancy interval of less than 2 years, which reduced the risk by 84% (95% CI: 0.07-0.37), and appropriate weight gain for pregnancy, which reduced the risk by 57% (95% CI: 0.22-0.85).
Conclusion: Screening for preterm birth risk factors, managing high-risk pregnancies such as those with diabetes or multiple gestations, and ensuring appropriate self-care during pregnancy to achieve recommended weight gain are critical components of maternal healthcare. Effective family planning, including maintaining an adequate interval between pregnancies, also plays a significant role. Adherence to established prenatal care protocols and comprehensive patient education are essential strategies to mitigate the incidence of preterm births.