Researchers in Ethiopia studied 321 mothers to understand why some babies are born before they’re fully ready (before 37 weeks of pregnancy). They found that mothers living in cities were less likely to have early babies, while mothers with large families, babies born too close together, no prenatal checkups, or missing important vitamins during pregnancy were more likely to have early babies. These findings help doctors and health workers understand what puts pregnancies at risk and how to better support mothers.

The Quick Take

  • What they studied: What factors make babies more likely to be born early (before 37 weeks of pregnancy)?
  • Who participated: 321 mothers at public hospitals in Bahir Dar, Ethiopia between September and December 2024. This included 107 mothers who had early babies and 214 mothers who had babies at the right time.
  • Key finding: Five main factors affected early birth: Living in a city actually protected against early birth, while having 6+ children in the family, babies born less than 2 years apart, skipping prenatal checkups, and not taking iron and folic acid vitamins during pregnancy all increased the risk of early birth.
  • What it means for you: If you’re pregnant or planning to be, regular prenatal checkups and taking recommended vitamins matter. Spacing pregnancies at least 2 years apart and living in areas with better healthcare access may help prevent early birth. However, these findings are specific to Ethiopia and may not apply everywhere.

The Research Details

Researchers used a case-control study design, which is like comparing two groups to find differences. They looked at mothers who had early babies (cases) and compared them to mothers who had babies at the right time (controls). They collected information about each mother’s living situation, family size, pregnancy spacing, prenatal care, and vitamin use. The researchers used a fair selection method called systematic sampling to choose participants, meaning they selected every nth person from the hospital records to avoid bias.

This type of study is useful for understanding what factors are connected to early birth because researchers can look backward at what happened during pregnancy and compare the two groups. The study was conducted at public referral hospitals, which are larger hospitals that handle more complicated cases, so the findings may be most relevant to mothers in similar hospital settings.

Case-control studies are good for studying problems like early birth because they’re faster and less expensive than following mothers forward through their entire pregnancy. By comparing mothers who had early babies with those who didn’t, researchers can identify patterns and risk factors. This helps doctors know which mothers need extra attention and support during pregnancy.

The study had a 100% response rate, meaning everyone who was asked to participate did so, which is excellent. The researchers used proper statistical methods to analyze the data and set a clear standard for what counts as a real finding (p-value less than 0.05). However, because this study was done only in one city in Ethiopia, the results may not apply to all populations. The study also relied on information mothers remembered about their pregnancies, which could sometimes be inaccurate.

What the Results Show

The research identified five main factors connected to early birth. Living in an urban area (city) was protective—mothers in cities were about 5 times less likely to have early babies compared to rural mothers. This likely reflects better access to healthcare in cities.

On the other hand, mothers with 6 or more children in their family were about 29 times more likely to have early babies. This suggests that having many children may strain a mother’s body. Mothers who had babies less than 2 years apart were about 17 times more likely to have early babies, showing that the body needs time to recover between pregnancies.

Mothers who didn’t attend prenatal checkups were 5 times more likely to have early babies, and mothers who didn’t take iron with folic acid supplements during pregnancy were also 5 times more likely to have early babies. These findings show that regular medical care and proper nutrition during pregnancy are crucial.

The study focused on five main factors, but the research suggests that maternal behavior patterns and nutritional status are important areas that hadn’t been studied as much before. The findings highlight that simple, preventable factors like taking vitamins and attending checkups can make a big difference in preventing early birth.

Previous research had already shown that maternal age, prenatal care, and birth spacing matter for early birth. This study confirms those findings and adds new information about family size and the protective effect of living in urban areas. The strong connection between large family size and early birth is particularly important because it hadn’t been emphasized as much in earlier studies.

This study was done only in one city in Ethiopia, so the results may not apply to other countries or regions with different healthcare systems. The study relied on mothers remembering details about their pregnancies, which could be inaccurate. The researchers couldn’t prove that these factors directly cause early birth—only that they’re connected. Additionally, the study was conducted at referral hospitals, which handle more complicated cases, so results may not represent all pregnancies.

The Bottom Line

Pregnant mothers should attend all prenatal checkups (moderate to high confidence). Take iron and folic acid supplements as recommended by healthcare providers (moderate to high confidence). Space pregnancies at least 2 years apart when possible (moderate confidence). If you live in a rural area, seek care at the best healthcare facility available (moderate confidence). These recommendations are based on this Ethiopian study and may need adjustment based on your personal health situation.

Pregnant mothers and those planning pregnancy should pay attention to these findings. Healthcare workers and public health officials in Ethiopia and similar settings should use this information to improve prenatal care programs. Women with large families or closely spaced pregnancies should be considered higher risk and receive extra support. However, women in countries with very different healthcare systems may find different factors are most important.

The benefits of prenatal care and vitamin supplements develop throughout pregnancy, with the most critical periods being the first and second trimesters. Spacing pregnancies properly requires planning before the next pregnancy. Improvements in early birth rates from these interventions would likely be seen within months to a year if programs are implemented.

Want to Apply This Research?

  • Track prenatal appointment attendance and iron/folic acid supplement intake daily. Users can log each appointment completed and each day vitamins were taken, creating a visual record of adherence.
  • Set reminders for prenatal appointments at least monthly and daily reminders for taking iron and folic acid supplements. Users can also track the time between pregnancies (if applicable) to ensure at least 2 years spacing.
  • Create a dashboard showing prenatal care completion percentage and supplement adherence rate. Include a timeline feature showing pregnancy spacing intervals. Generate monthly reports comparing actual vs. recommended prenatal visits and supplement doses taken.

This research is specific to mothers delivering at public hospitals in Bahir Dar, Ethiopia, and may not apply to all populations or healthcare settings. Early birth has many causes, and this study identifies associated factors, not definitive causes. Always consult with your healthcare provider about your individual pregnancy risks and care plan. This information is for educational purposes and should not replace professional medical advice. If you are pregnant or planning pregnancy, discuss these findings with your doctor to determine what’s most relevant for your situation.