Spontaneous Preterm Births in Malaysia: Are There Modifiable Antenatal Risk Factors?

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Maternal-Fetal Medicine

Background:

• Spontaneous preterm birth (SPB) presents a significant global health challenge with severe consequences for affected infants.
• Identifying modifiable antenatal risk factors is essential for developing targeted interventions.

Purpose of the Study:

• To investigate modifiable antenatal risk factors associated with spontaneous preterm birth (SPB) in Malaysian women.
• To analyze national obstetrics registry data to identify key predictors of SPB.

Main Methods:

• Retrospective analysis of 49,416 records from the 2015 Malaysian national obstetrics registry.
• Binary logistic regression was employed to assess the association between antenatal factors and SPB.

Main Results:

• Pre-existing diabetes (aOR=3.09), chronic hypertension with superimposed pre-eclampsia (aOR=2.51), and gestational hypertension (aOR=1.44) significantly increased SPB odds.
• Underweight mothers (aOR=1.27) and those with moderate anemia (aOR=1.18) also showed higher odds of preterm delivery.
• Maternal glucose, blood pressure, BMI, and hemoglobin levels are critical biomarkers for SPB risk.

Conclusions:

• Maternal biomarkers including glucose, blood pressure, BMI, and hemoglobin are vital in mitigating SPB rates in Malaysia.
• Strengthening comprehensive antenatal care, encompassing preventive and curative strategies, is recommended.
• Multidisciplinary and multi-agency collaboration is essential for addressing both modifiable and non-modifiable risk factors effectively.