Prevalence and determinants of preterm birth among women of reproductive age in Kenya: a multilevel analysis of the 2022 Demographic Health Survey.

BACKGROUND

Globally, over 15 million preterm births (PTB) occur annually, with sub-Saharan Africa bearing a disproportionate burden. In Kenya, studies conducted between 2017 and 2021 at the hospital level show a PTB prevalence ranging from 15.9% to 20.2%. However, current PTB prevalence and associated factors remain underexplored despite their significant public health implications. Understanding the prevalence and factors associated with PTB is critical for effective interventions.

OBJECTIVES

This study aimed to determine the prevalence of PTB and also to identify individual- and community-level factors influencing PTB among women of reproductive age in Kenya.

DESIGN

The study utilised a cross-sectional design, analysing data from the 2022 Kenya Demographic and Health Survey.

METHODS

A sample of 7291 women aged 15-49 was analysed using weighted multilevel logistic regression in Stata 17.0. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) and a significance threshold of  < 0.05 were used to identify predictors of PTB.

RESULTS

The prevalence of PTB was 7.14%. Women aged 25-34 (aOR = 0.67; 95% CI: 0.49-0.94) and 35+ (aOR = 0.86; 95% CI: 0.59-1.24) were less likely to experience PTB compared to younger women (15-24 years). Attending four or more antenatal care visits reduced PTB likelihood (aOR = 0.68; 95% CI: 0.53-0.88). Women in the richest wealth index had higher odds of PTB (aOR = 2.28; 95% CI: 1.39-3.74), while medium community literacy levels increased PTB risk (aOR = 1.56; 95% CI: 1.21-2.03).

CONCLUSION

This study highlights that individual- and community-level factors significantly influence PTB in Kenya. Addressing disparities in socio-demographic and obstetric factors through targeted, multipronged strategies is essential for reducing PTB rates and improving maternal and neonatal outcomes.