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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
Authors: Tesfa Sewunet Alamneh, Achamyeleh Birhanu Teshale, Misganaw Gebrie Worku, Zemenu Tadesse Tessema, Yigizie Yeshaw, Getayeneh Antehunegn Tesema, Alemneh Mekuriaw Liyew, and Adugnaw Zeleke Alem
Source: BMC Pregnancy and Childbirth , Volume 21, issue 770; DOI:
Topic(s): Antenatal care
Infant mortality
Pregnancy outcomes
Country: Africa
  Multiple African Countries
Published: NOV 2021
Abstract: Background: Globally, preterm birth is the leading cause of neonatal and under-five children mortality. Sub-Saharan African (SSA) accounts for the majority of preterm birth and death following its complications. Despite this, there is limited evidence about the pooled prevalence and associated factors of preterm birth at SSA level using nation-wide representative large dataset. Therefore, this study aimed to determine the pooled prevalence and associated factors of preterm birth among reproductive aged women. Methods: The recent Demographic and Health Surveys (DHSs) data of 36 SSA countries were used. We included a total weighted sample of 172,774 reproductive-aged women who were giving birth within five years preceding the most recent survey of SSA countries were included in the analysis. We used a multilevel logistic regression model to identify the associated factors of preterm birth in SSA. We considered a statistical significance at a p-value less than 0.05. Results: In this study, 5.33% (95% CI: 5.23, 5.44%) of respondents in SSA had delivered preterm baby. Being form eastern Africa, southern Africa, rural area, being educated, substance use, having multiple pregnancy, currently working history, having history of terminated pregnancy, and previous cesarean section delivery, primi-parity, and short birth interval were associated with higher odds of preterm birth among reproductive aged women. However, having better wealth index, being married, wanted pregnancy, and having four or more antenatal care visit were associated with lower odds for a preterm birth among reproductive aged women. Conclusion: The prevalence of preterm birth among reproductive-aged women remains a major public health problem in SSA. Preterm birth was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during intervention to prevent the short-term and long-term consequences of preterm birth. Keywords: Demographic and health survey; Multilevel analysis; Premature birth; Preterm birth; Reproductive age women; Sub-Saharan Africa.