Epidemiology of Preterm Birth and Associated Risk Factors at Tertiary Hospitals in the North East Zone

Preterm birth is the leading cause of neonatal mortality worldwide, and Nigeria bears one of the highest preterm birth burdens globally, yet zone-specific epidemiological data from the North East remain sparse. This study determines the epidemiology of preterm birth and identifies independently associated risk factors at tertiary hospitals in Borno, Gombe, and Adamawa States, North East Nigeria. A prospective cohort study enrolled 350 women delivering at Federal Teaching Hospital Gombe, University of Maiduguri Teaching Hospital, and Specialist Hospital Yola over 12 months. Preterm birth was defined as delivery before 37 completed weeks. Gestational age was confirmed by first-trimester ultrasound where available and Ballard score for those without early scan. Multivariable logistic regression identified independent risk factors. Preterm birth rate was 17.4 percent. Antepartum haemorrhage (OR 4.6), preeclampsia (OR 3.9), bacterial vaginosis (OR 2.8), prior preterm birth (OR 3.4), and unintended pregnancy (OR 2.1) were independently associated with preterm birth. Teenage pregnancy was associated with 2.4-fold elevated preterm risk. Unbooked status was present in 52 percent of preterm deliveries. The study provides an epidemiological baseline for preterm birth prevention planning in the North East and advocates for universal bacterial vaginosis screening, preeclampsia prevention protocols, and adolescent-targeted reproductive health services. Keywords: preterm birth, epidemiology, North East Nigeria, risk factors, neonatal mortality