Maternal correlates of spontaneous preterm birth in Kazakhstan: a matched case-control study

Author:

Oralkhan Zhibek1ORCID,Sarsenova Lazzat1ORCID,Kopbayeva Maira2ORCID,Tastambek Kuanysh1ORCID,Grjibovski Andrej M.13452ORCID,Berdalinova Akzhenis13ORCID,Balmagambetova Aru3ORCID,Zhurabekova Gulmira13ORCID

Affiliation:

1. Al-Farabi Kazakh National University

2. Asfendiyarov Kazakh National Medical University

3. West Kazakhstan Marat Ospanov State Medical University

4. Northern State Medical University

5. Northern (Arctic) Federal University

Abstract

BACKGROUND: Preterm birth (PTB) continues to be a persistent health issue that significantly impacts neonatal morbidity and mortality worldwide. In Kazakhstan, the prevalence of PTB is 7% making a substantial contribution to adverse health outcomes among infants. However, there is a lack of comprehensive research on the factors contributing to PTB in Kazakhstan. AIM: To study maternal factors associated with spontaneous PTB among Kazakh women. MATERIAL AND METHODS: A case control study was conducted in three major reproductive hospitals in Atyrau, Aktobe and Kyzylorda from October 2022 to January 2023. The sample consisted of 90 cases with singleton live spontaneous PTB and 180 controls with spontaneous full-term delivery. Bivariate associations between categorical variables were assessed by chi-squared tests. Independent variables with p 0.1 in the bivariate analysis were entered into a conditional logistic regression model. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. RESULTS: Maternal education, periodontitis, body mass index and a history of PTB in previous pregnancies were associated with PTB in bivariate analysis. In multivariable models, only prior PTB (OR=38.10; 95% CI: 8.34–142.00) and periodontal disease (OR=2.09; 95% CI: 1.15–3.80) were associated with an increased risk of extremely and very preterm births while higher education (OR=0.44; 95% CI: 0.19–0.98) and a history of PTB (OR=27.20; 95% CI: 5.38–137.00) were associated with moderate to late PTB. CONCLUSION: Our results are in line with the international evidence on prior PTB being the most important determinant of PTB in the index pregnancy. Moreover, our findings on the associations with periodontal disease underline the importance of a targeted, individualized and interdisciplinary antenatal care to the reduction in the prevalence of PTB.

Publisher

ECO-Vector LLC

Reference40 articles.

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5. National Guideline Alliance (UK). Developmental follow-up of children and young people born preterm. London: National Institute for Health and Care Excellence (NICE); August 2017.

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