Prognostic significance of risk factors for preterm birth: a retrospective cohort study
DOI:
https://doi.org/10.37800/RM.1.2025.461Keywords:
preterm birth, risk factors, isthmic-cervical insufficiency, preventionAbstract
Relevance: Preterm birth (PTB), occurring before the 37th week of gestation, remains one of the leading causes of neonatal mortality and morbidity worldwide. According to WHO data, the prevalence of PTB varies from 5% to 16%, while in Kazakhstan, it is approximately 6.4%. Preterm infants are at high risk of severe complications, including respiratory distress syndrome, neurological disorders, and delayed growth and development.
PTB etiology is multifactorial; it includes obstetric, somatic, and socio-demographic predictors. Identifying risk factors' prevalence and prognostic significance allows for developing effective prevention strategies and improving perinatal outcomes.
The study aimed to determine the frequency, prevalence, and prognostic significance of risk factors for preterm birth to develop effective preventive measures.
Materials and Methods: The study was conducted using a retrospective cohort design. Medical records of 1,000 women with PTB and 500 women who delivered at term at the Center for Perinatology and Pediatric Cardiac Surgery in Almaty between 2021 and 2022 were analyzed. Demographic, medical, obstetric, and social risk factors were assessed. Logistic regression methods were used for statistical analysis.
Results: According to the analysis, the most significant risk predictors are polyhydramnios (OR = 11.0, p < 0.001), multiple pregnancies (OR = 8.37, p < 0.001), cervical insufficiency (OR = 6.15, p < 0.001), a history of preterm birth (OR = 6.08, p < 0.001), and uterine anomalies (OR = 5.93, p = 0.02). These factors impact pregnancy outcomes most and require special attention during antenatal care.
Conclusion: The identified predictors highlight the importance of early diagnosis and monitoring of pregnant women at high risk, especially in cases of polyhydramnios, multiple pregnancies, and pathological conditions of the cervix characterized by its premature shortening and dilation. Timely medical intervention, including dynamic monitoring, correction of comorbid conditions, and prevention of complications, are vital for reducing adverse outcomes. These findings can be used in clinical practice to develop personalized pregnancy management programs to reduce complications and improve perinatal outcomes.
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