Maternal And Obstetric Factors Associated With Preterm Birth In Pregnancies Complicated By Placenta Previa: A Single-Center Study

Abstract

Background

Preterm birth remains a major contributor to neonatal morbidity and mortality worldwide. Placenta previa is a high-risk obstetric condition frequently associated with preterm delivery; however, the role of specific maternal and obstetric factors in predicting preterm birth among affected pregnancies remains incompletely understood, particularly in resource-limited settings.

Objective

To identify maternal and obstetric factors associated with preterm birth among pregnancies complicated by placenta previa at a tertiary care center.

Methods

This observational analytical study was conducted at Mardan Medical Complex, Mardan, from July to December 2022. Pregnant women with a confirmed diagnosis of placenta previa and singleton gestation were consecutively enrolled and followed until delivery. Preterm birth was defined as delivery before 37 completed weeks of gestation. Maternal characteristics and obstetric variables, including booking status, previous cesarean section, type and location of placenta previa, gestational age at diagnosis, and antepartum hemorrhage, were recorded. Data were analyzed using SPSS version 26. Associations between maternal and obstetric factors and preterm birth were assessed using Chi-square tests and independent-samples t-tests, with a significance level of p ≤ 0.05.

Results

A total of 150 women with placenta previa were included. Preterm birth occurred in approximately two-thirds of the study population, indicating a high burden of early delivery in this cohort. Maternal age and gestational age at diagnosis did not differ significantly between women who delivered preterm and those who delivered at term. Furthermore, no statistically significant associations were observed between preterm birth and booking status, history of previous cesarean section, type of placenta previa, placental location, or presence of antepartum hemorrhage. Multivariable analysis was not pursued due to the absence of significant univariate associations and instability of the regression model.

Conclusion

Pregnancies complicated by placenta previa are associated with a high frequency of preterm birth, irrespective of identifiable maternal or obstetric risk factors. These findings suggest that placenta previa itself constitutes an intrinsic risk for preterm delivery, underscoring the importance of vigilant antenatal surveillance and delivery planning for all affected women. The study provides valuable context-specific evidence from a tertiary care setting and highlights the need for proactive obstetric management in pregnancies complicated by placenta previa.