Maternal correlates of spontaneous preterm birth in Kazakhstan: a matched case-control study

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Abstract

BACKGROUND: Preterm birth (PTB) continues to be a persistent health issue that significantly impacts neonatal morbidity and mortality worldwide. In Kazakhstan, the prevalence of PTB is 7% making a substantial contribution to adverse health outcomes among infants. However, there is a lack of comprehensive research on the factors contributing to PTB in Kazakhstan.

AIM: To study maternal factors associated with spontaneous PTB among Kazakh women.

MATERIAL AND METHODS: A case control study was conducted in three major reproductive hospitals in Atyrau, Aktobe and Kyzylorda from October 2022 to January 2023. The sample consisted of 90 cases with singleton live spontaneous PTB and 180 controls with spontaneous full-term delivery. Bivariate associations between categorical variables were assessed by chi-squared tests. Independent variables with p <0.1 in the bivariate analysis were entered into a conditional logistic regression model. Odds ratios (OR) with 95% confidence intervals (CI) were calculated.

RESULTS: Maternal education, periodontitis, body mass index and a history of PTB in previous pregnancies were associated with PTB in bivariate analysis. In multivariable models, only prior PTB (OR=38.10; 95% CI: 8.34–142.00) and periodontal disease (OR=2.09; 95% CI: 1.15–3.80) were associated with an increased risk of extremely and very preterm births while higher education (OR=0.44; 95% CI: 0.19–0.98) and a history of PTB (OR=27.20; 95% CI: 5.38–137.00) were associated with moderate to late PTB.

CONCLUSION: Our results are in line with the international evidence on prior PTB being the most important determinant of PTB in the index pregnancy. Moreover, our findings on the associations with periodontal disease underline the importance of a targeted, individualized and interdisciplinary antenatal care to the reduction in the prevalence of PTB.

About the authors

Zhibek Oralkhan

Al-Farabi Kazakh National University

Email: september_becca@hotmail.com
ORCID iD: 0000-0002-8884-6523
Scopus Author ID: 56892790400

MD

Kazakhstan, 71 al-Farabi Ave., Almaty, 050040

Lazzat Sarsenova

Al-Farabi Kazakh National University

Email: lazzat.sarsenova@kaznu.kz
ORCID iD: 0000-0001-8643-0703

PhD

Kazakhstan, 71 al-Farabi Ave., Almaty, 050040

Maira Kopbayeva

Asfendiyarov Kazakh National Medical University

Email: m_kopbay@mail.ru
ORCID iD: 0000-0002-7439-5573

MD, PhD, Professor

Kazakhstan, Almaty

Kuanysh Tastambek

Al-Farabi Kazakh National University

Email: tastambeku@gmail.com
ORCID iD: 0000-0002-2338-8816

PhD

Kazakhstan, Almaty

Andrej M. Grjibovski

Al-Farabi Kazakh National University; West Kazakhstan Marat Ospanov State Medical University; Northern State Medical University; Northern (Arctic) Federal University; Asfendiyarov Kazakh National Medical University

Email: a.grjibovski@yandex.ru
ORCID iD: 0000-0002-5464-0498
SPIN-code: 5118-0081

MD, MPhil, PhD

Kazakhstan, Arkhangelsk; Arkhangelsk; Almaty; 71 al-Farabi Ave., Almaty, 050040; Aktobe

Akzhenis Berdalinova

Al-Farabi Kazakh National University; West Kazakhstan Marat Ospanov State Medical University

Email: berdalinova77@mail.ru
ORCID iD: 0000-0002-5735-9538
Kazakhstan, 71 al-Farabi Ave., Almaty, 050040; Aktobe

Aru Balmagambetova

West Kazakhstan Marat Ospanov State Medical University

Email: aru.b.84@mail.ru
ORCID iD: 0000-0003-1151-5651

PhD

Kazakhstan, Aktobe

Gulmira Zhurabekova

Al-Farabi Kazakh National University; West Kazakhstan Marat Ospanov State Medical University

Author for correspondence.
Email: zhurabekova.gulmira@kaznu.kz
ORCID iD: 0000-0002-2166-3095

MD, PhD, Associated Professor

Kazakhstan, 71 al-Farabi Ave., Almaty, 050040; Aktobe

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