Ajayi, Kobi V., Bolarinwa, Obasanjo ORCID: https://orcid.org/0000-0002-9208-6408, Adekunle, Toluwani E., Alawode, Oluwatobi Abe, Siuluta, Nanyangwe, Shongwe, Sinegugu and McCallum, Edyta (2025) Prevalence and determinants of preterm birth among women of reproductive age in Kenya: A Multilevel Analysis of the 2022 Demographic Health Survey. Therapeutic Advances in Reproductive Health, 19.

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Abstract

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 p < 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.

Item Type:	Article
Status:	Published
DOI:	10.1177/26334941251327181
School/Department:	London Campus
URI:	https://ray.yorksj.ac.uk/id/eprint/11685

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