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We identified and combined demographic, clinical, and psychosocial correlates of PTB among Kenyan women to develop a risk score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from a prospective study enrolling HIV-negative women from 20 antenatal clinics in Western Kenya (NCT03070600). Depressive symptoms were assessed by study nurses using the Center for Epidemiologic Studies Depression Scale (CESD-10), intimate partner violence (IPV) with the Hurt, Insult, Threaten, Scream scale (HITS), and social support using the Medical Outcomes Survey scale (MOS-SSS). Predictors of PTB (birth\u2009&lt;\u200937 weeks gestation) were identified using multivariable Cox proportional hazards models, clustered by facility. We used stratified k-fold cross-validation methods for risk score derivation and validation. Area under the receiver operating characteristic curve (AUROC) was used to evaluate discrimination of the risk score and Brier score for calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 4084 women, 19% had PTB (incidence rate: 70.9 PTB per 100 fetus-years (f-yrs)). Predictors of PTB included being unmarried (HR:1.29, 95% CI:1.08\u20131.54), lower education (years) (HR:0.97, 95% CI:0.94\u20130.99), IPV (HITS score\u2009\u2265\u20095, HR:1.28, 95% CI:0.98\u20131.68), higher CESD-10 score (HR:1.02, 95% CI:0.99\u20131.04), lower social support score (HR:0.99, 95% CI:0.97\u20131.01), and mild-to-severe depressive symptoms (CESD-10 score\u2009\u2265\u20095, HR:1.46, 95% CI:1.07\u20131.99). The final risk score included being unmarried, social support score, IPV, and MSD. The risk score had modest discrimination between PTB and term deliveries (AUROC:0.56, 95% CI:0.54\u20130.58), and Brier Score was 0.4672. Women considered \u201chigh risk\u201d for PTB (optimal risk score cut-point) had 40% higher risk of PTB (83.6 cases per 100 f-yrs) than \u201clow risk\u201d women (59.6 cases per 100 f-ys; HR:1.6, 95% CI:1.2\u20131.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A fifth of pregnancies were PTB in this large multi-site cohort; PTB was associated with several social factors amenable to intervention. Combining these factors in a risk score did not predict PTB, reflecting the multifactorial nature of PTB and need to include other unmeasured factors. However, our findings suggest PTB risk could be better understood by integrating mental health and support services into routine antenatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-024-07058-x","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T19:58:31Z","timestamp":1735847911000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying psychosocial predictors and developing a risk score for preterm birth among Kenyan pregnant women"],"prefix":"10.1186","volume":"25","author":[{"given":"Anna","family":"Larsen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jillian","family":"Pintye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Abuna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julia C.","family":"Dettinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laur\u00e9n","family":"Gomez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary M.","family":"Marwa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Ngumbau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Odhiambo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbra A.","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salphine","family":"Watoyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Stern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Kinuthia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace","family":"John-Stewart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"7058_CR1","unstructured":"You D, Hug L, Ejdemyr S, Beise J, Idele P, UN IGME. 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We also received approval from Siaya and Homabay county Departments of Health and facility administrators. All participants provided written informed consent. All study procedures were performed in accordance with guidelines and regulations for research involving human subjects. This trial was registered at ClinicalTrials.gov on January 15, 2018 (NCT03070600). The Community Advisory Board for HIV\/AIDS related studies among the Kenyatta National Hospital and University of Washington collaboration provided feedback to the parent study protocol.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"2"}}