Maternal factors in premature birth: a register analysis

Objective. To assess the structure of maternal extragenital and gynecological morbidity, as well as pregnancy complications, depending on gestational age in preterm births using national registry data.

Materials and methods. An analytical cross-sectional study was conducted using anonymized data from the national registry of preterm infants in the Republic of Belarus. The analysis included data on maternal health for 2660 preterm births registered in 2023; records with incomplete information were excluded. Pregnancies were stratified into four gestational age groups: < 28 weeks, 28–31 weeks, 32–33 weeks, 34–36 weeks. Extragenital and gynecological diseases, as well as pregnancy complications, were analyzed. Descriptive statistics, Pearson’s χ² test, Fisher’s exact test, and χ² test for trends were applied; p < 0.05 was considered statistically significant.

Results. Maternal morbidity patterns varied significantly by gestational age. Early preterm birth was predominantly associated with infectious and inflammatory pregnancy complications, cervical insufficiency, placental pathology, and chorioamnionitis. With increasing gestational age, higher prevalence of anemia, disorders of carbohydrate metabolism, and extragenital conditions was observed. Statistically significant trends were identified for anemia, gestational diabetes mellitus, threatened miscarriage, and infection-related risks.

Conclusion. The findings demonstrate the heterogeneity of maternal risk factors for preterm birth and support the use of registry-based, risk-stratified approaches to antenatal care aimed at preventing preterm birth and improving perinatal outcomes.

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