Risk Factors for Preterm Birth: A Comprehensive Review of Current Evidence
DOI:
https://doi.org/10.12775/QS.2025.40.59773Keywords
Preterm birth, Risk factors, Obstetric complications, Maternal health, Pregnancy complications, Assisted reproductive technology (ART), Perinatal careAbstract
Preterm birth, defined as the termination of pregnancy before the completion of 37 weeks of gestation, remains one of the most critical challenges in contemporary perinatal care. High neonatal mortality rates, along with frequent neurological, respiratory, and developmental complications, underscore the importance of identifying risk factors associated with preterm labor. The aim of this review was to comprehensively synthesize current scientific evidence on the multifactorial etiology of preterm birth, encompassing biological, immunological, genetic, environmental, and socio-economic determinants. A systematic literature search was conducted in PubMed during January and February 2025, covering peer-reviewed publications from 2020 to 2024. Included in the analysis were meta-analyses, cohort studies, case-control studies, systematic reviews, and population-based analyses.
The findings indicate a significant association between preterm birth and obstetric abnormalities, maternal comorbidities, inflammatory and genetic factors, as well as low socioeconomic status and limited access to prenatal care. In high-income countries, assisted reproductive technologies (ART), particularly fresh embryo transfer, continue to pose a considerable risk. The conclusions emphasize the need for an interdisciplinary approach to prevention, standardization of diagnostic criteria, and further development of biomarker-based tools and personalized strategies for perinatal care.
References
Agarwal, R., & Agrawal, R. (2024). Exploring Risk Factors and Perinatal Outcomes of Preterm Birth in a Tertiary Care Hospital: A Comprehensive Analysis. Cureus, 16(2), e53673. https://doi.org/10.7759/cureus.53673
Bryce, E., Gurung, S., Tong, H., Katz, J., Lee, A. C. C., Black, R. E., & Walker, N. (2022). Population attributable fractions for risk factors for spontaneous preterm births in 81 low- and middle-income countries: A systematic analysis. Journal of Global Health, 12, 04013. https://doi.org/10.7189/jogh.12.04013
Cobo, T., Kacerovsky, M., & Jacobsson, B. (2020). Risk factors for spontaneous preterm delivery. International Journal of Gynecology & Obstetrics, 150(1), 17–23. https://doi.org/10.1002/ijgo.13184
Couceiro, J., Matos, I., Mendes, J. J., Baptista, P. V., Fernandes, A. R., & Quintas, A. (2021). Inflammatory factors, genetic variants, and predisposition for preterm birth. Clinical Genetics, 100(4), 357–367. https://doi.org/10.1111/cge.14001
Díaz-Rodríguez, A., Feliz-Matos, L., & Ruiz Matuk, C. B. (2021). Risk factors associated with preterm birth in the Dominican Republic: A case-control study. BMJ Open, 11(12), e045399. https://doi.org/10.1136/bmjopen-2020-045399
Etil, T., Opio, B., Odur, B., Lwanga, C., & Atuhaire, L. (2023). Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital. BMC Pregnancy and Childbirth, 23, Article 814. https://doi.org/10.1186/s12884-023-06120-4
Gervoise-Boyer, M.-J., Fauque, P., De Mouzon, J., Devaux, A., Epelboin, S., Levy, R., Valentin, M., Viot, G., Bonomini, J., Bergère, M., Jonveaux, P., & Pessione, F. (2023). Risk factors associated with preterm birth in singletons born after IVF: A national cohort study. Reproductive BioMedicine Online, 46(4), 750–759. https://doi.org/10.1016/j.rbmo.2023.01.011
Gyamtsho, S., Tenzin, K., & Choeda, T. (2023). Maternal risk factors associated with preterm birth: A case control study. Journal of Nepal Health Research Council, 21(3), 505–513. https://doi.org/10.33314/jnhrc.v21i3.4933
Ji, X., Wu, C., Chen, M., Wu, L., Li, T., Miao, Z., Lv, Y., & Ding, H. (2022). Analysis of risk factors related to extremely and very preterm birth: A retrospective study. BMC Pregnancy and Childbirth, 22(1), 818. https://doi.org/10.1186/s12884-022-05119-7
Khandre, V., Potdar, J., & Keerti, A. (2022). Preterm birth: An overview. Cureus, 14(12), e33006. https://doi.org/10.7759/cureus.33006
Kinjyo, Y., Kinjo, T., Mekaru, K., Nagai, Y., Moromizato, T., Ohata, T., Iseki, C., Iseki, K., & Aoki, Y. (2023). Risk Factors of Preterm Birth in Okinawa Prefecture, the Southernmost Island Prefecture of Japan. Maternal and Child Health Journal, 27(1), 92–100. https://doi.org/10.1007/s10995-022-03530-2
Landman, A. J. E. M. C., Don, E. E., Vissers, G., Ket, H. C. J., Oudijk, M. A., de Groot, C. J. M., Huirne, J. A. F., & de Boer, M. A. (2022). The risk of preterm birth in women with uterine fibroids: A systematic review and meta-analysis. PLOS ONE, 17(6), e0269478. https://doi.org/10.1371/journal.pone.0269478
Li, J., Shen, J., Zhang, X., Peng, Y., Zhang, Q., Hu, L., Reichetzeder, C., Zeng, S., Li, J., Tian, M., Gong, F., Lin, G., & Hocher, B. (2022). Risk factors associated with preterm birth after IVF/ICSI. Scientific Reports, 12, Article 7944. https://doi.org/10.1038/s41598-022-12149-w
Mitrogiannis, I., Evangelou, E., Efthymiou, A., Kanavos, T., Birbas, E., Makrydimas, G., & Papatheodorou, S. (2023). Risk factors for preterm birth: An umbrella review of meta-analyses of observational studies. BMC Medicine, 21, 456. https://doi.org/10.1186/s12916-023-03171-4
Seetho, S., Kongwattanakul, K., Saksiriwuttho, P., & Thepsuthammarat, K. (2023). Epidemiology and factors associated with preterm births in multiple pregnancy: A retrospective cohort study. BMC Pregnancy and Childbirth, 23(1), 872. https://doi.org/10.1186/s12884-023-06186-0
Sendeku, F. W., Beyene, F. Y., Tesfu, A. A., Bante, S. A., & Azeze, G. G. (2021). Preterm birth and its associated factors in Ethiopia: A systematic review and meta-analysis. African Health Sciences, 21(3), 1321–1333. https://doi.org/10.4314/ahs.v21i3.43
Tang, I. D., Mallia, D., Yan, Q., Pe'er, I., Raja, A., Salleb-Aouissi, A., & Wapner, R. (2024). A scoping review of preterm birth risk factors. American Journal of Perinatology, 41(S 01), e2804–e2817. https://doi.org/10.1055/s-0043-1775564
Torremante, P., Berge, N. K., & Weiss, C. (2023). Reducing the rate of premature births through early diagnosis and pregnancy-adapted treatment of hypothyroidism. Geburtshilfe und Frauenheilkunde, 83(11), 1361–1370. https://doi.org/10.1055/a-2103-8143
Wu, S.-T., Lin, C.-H., Lin, Y.-H., Hsu, Y.-C., Hsu, C.-T., & Lin, M.-C. (2023). Maternal risk factors for preterm birth in Taiwan: A nationwide population-based cohort study. Pediatrics and Neonatology, 64(5), 588–595. https://doi.org/10.1016/j.pedneo.2023.03.014
Ye, C.-X., Chen, S.-B., Wang, T.-T., Zhang, S.-M., Qin, J.-B., & Chen, L.-Z. (2021). Risk factors for preterm birth: A prospective cohort study. Chinese Journal of Contemporary Pediatrics, 23(12), 1242–1249. https://doi.org/10.7499/j.issn.1008-8830.2108015
Younes, S., Samara, M., Al-Jurf, R., Nasrallah, G., Al-Obaidly, S., Salama, H., Olukade, T., Hammuda, S., Ismail, M. A., Abdoh, G., Abdulrouf, P. V., Farrell, T., AlQubaisi, M., Al Rifai, H., & Al-Dewik, N. (2021). Incidence, risk factors, and outcomes of preterm and early term births: A population-based register study. International Journal of Environmental Research and Public Health, 18(11), 5865. https://doi.org/10.3390/ijerph18115865
Zhang, Y.-J., Shen, J., Lin, S. B., Lu, C., Jiang, H., Sun, Y., Cheng, X., Wang, H., Cui, S., Liu, X., Huang, L., Lin, X., Zhao, G., Yang, L., & Chen, C. (2022). The risk factors of preterm birth: A multicentre case-control survey in China in 2018. Journal of Paediatrics and Child Health, 58(8), 1396–1406. https://doi.org/10.1111/jpc.16002
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Copyright (c) 2025 Julia Piekarska, Justyna Maria Solarz, Jakub Tomasz Wawrzyńców, Weronika Cyrkler, Jakub Robak, Stanisław Telega, Paweł Bollin, Urszula Szymczak, Wojciech Wiesław Lachór, Monika Barbara Solarz
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