{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T18:10:16Z","timestamp":1756404616649,"version":"3.44.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Accurate measures of the burden of preterm live births are a challenge, particularly in low-and-middle income countries, due to factors including poor data quality and unreliable methods using last menstrual period (LMP) in determining gestational age of pregnancies. This study employed gestational age from first trimester ultrasound to determine incidence of preterm livebirths at Ho Teaching Hospital in Ghana, their risk factors and adverse outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a prospective study involving 666 pregnant women and their 680 live newborns from 1<jats:sup>st<\/jats:sup> October, 2019\u201331<jats:sup>st<\/jats:sup> March, 2020. Data was collected on socio-demographic characteristics such as age and for other variables including gestational age at delivery and birthweight. The primary outcome was overall preterm livebirth incidence. Logistic regression analysis was used to determine its predictors. Odds ratios were reported with 95% confidence intervals. Statistical significance was pegged at p-value &lt;0.05.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean age of the women was 29.0 years. About 93% (616\/666) had formal education. Overall preterm livebirth incidence was 9.1% (62\/680). Formal employment [AOR 6.84 (95% CI 1.63\u201328.73), p\u2009=\u20090.009], informal employment [AOR 4.98 (95% CI 1.39\u201317.85), p\u2009=\u20090.014] and hypertensive disorders in pregnancy (HDP) [AOR 6.43(95% CI 2.78\u201314.89); p\u2009&lt;\u20090.001] increased the odds of preterm livebirth. Adequate antenatal clinic contacts (ANC) [AOR 0.14 (95% CI 0.05\u20130.37), p\u2009&lt;\u20090.001] and doses of sulphadoxine-pyrimethamine for malaria prevention in pregnancy (IPTp) [AOR 0.21(0.10\u20130.45), p\u2009&lt;\u20090.001] reduced the odds of preterm livebirth by 86% and 79% respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Overall preterm livebirth incidence in the study compared favourably with global estimates. HDP and being employed were important risk factors and. suggest reducing workloads of pregnant women in formal employment may be beneficial. Targeted posting of specialists to aid adequate management of HDP at district hospitals and mitigating missed opportunities for IPTp need to be considered.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0331223","type":"journal-article","created":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T17:31:42Z","timestamp":1756402302000},"page":"e0331223","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, risk factors and outcomes of preterm live births in a tertiary health facility in Ghana"],"prefix":"10.1371","volume":"20","author":[{"given":"Anthony Kwame","family":"Dah","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5366-3997","authenticated-orcid":true,"given":"Joseph","family":"Osarfo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hintermann","family":"Mbroh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gifty Dufie","family":"Ampofo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7730-8252","authenticated-orcid":true,"given":"Adu","family":"Appiah-Kubi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wisdom Klutse","family":"Azanu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Amoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel Senanu Komla","family":"Morhe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"issue":"5","key":"pone.0331223.ref001","doi-asserted-by":"crossref","DOI":"10.1152\/ajplung.00479.2020","article-title":"World Prematurity Day: improving survival and quality of life for millions of babies born preterm around the world","volume":"319","author":"O Lincetto","year":"2020","journal-title":"Am J Physiol Lung Cell Mol Physiol"},{"issue":"1","key":"pone.0331223.ref002","doi-asserted-by":"crossref","DOI":"10.1016\/S2214-109X(18)30451-0","article-title":"Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis","volume":"7","author":"S Chawanpaiboon","year":"2019","journal-title":"Lancet Glob Health"},{"issue":"8","key":"pone.0331223.ref003","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1001\/jamapediatrics.2022.1622","article-title":"Global, regional, and national incidence and mortality of neonatal preterm birth, 1990-2019","volume":"176","author":"G Cao","year":"2022","journal-title":"JAMA Pediatr"},{"issue":"10409","key":"pone.0331223.ref004","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1016\/S0140-6736(23)00878-4","article-title":"National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis","volume":"402","author":"EO Ohuma","year":"2023","journal-title":"Lancet"},{"issue":"17","key":"pone.0331223.ref005","doi-asserted-by":"crossref","first-page":"10537","DOI":"10.3390\/ijerph191710537","article-title":"A Scoping Review of Preterm Births in Sub-Saharan Africa: Burden, Risk Factors and Outcomes","volume":"19","author":"A Mabrouk","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0331223.ref006","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.placenta.2020.04.016","article-title":"Challenges in preterm birth research: Ghanaian perspective","volume":"98","author":"K Adu-Bonsaffoh","year":"2020","journal-title":"Placenta"},{"key":"pone.0331223.ref007","first-page":"1","article-title":"Preterm birth: educational and mental health outcomes","author":"E O","year":"2021","journal-title":"Clin Child Psychol Psychiatry"},{"key":"pone.0331223.ref008","doi-asserted-by":"crossref","first-page":"04011","DOI":"10.7189\/jogh.12.04011","article-title":"Population-based rates, risk factors and consequences of preterm births in South-Asia and sub-Saharan Africa: A multi-country prospective cohort study","volume":"12","author":"Group The Alliance for Maternal and Newborn Health Improvement (AMANHI) GA Study","year":"2022","journal-title":"J Glob Health"},{"issue":"2","key":"pone.0331223.ref009","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4314\/njp.v50i2.1","article-title":"Risk factors and outcome of preterm births at a teaching hospital in Jos, North Central Nigeria","volume":"50","author":"MM Ihekaike","year":"2023","journal-title":"Niger J Paediatr"},{"issue":"1","key":"pone.0331223.ref010","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s13052-020-0772-1","article-title":"Determinants of preterm birth among mothers who gave birth in East Africa: systematic review and meta-analysis","volume":"46","author":"T Laelago","year":"2020","journal-title":"Ital J Pediatr"},{"key":"pone.0331223.ref011","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s13690-020-00446-7","article-title":"Incidence, risk factors and consequences of preterm birth - findings from a multi-centric observational study for 14\u2009months in Nepal","volume":"78","author":"A Gurung","year":"2020","journal-title":"Arch Public Health"},{"key":"pone.0331223.ref012","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2147\/PHMT.S174789","article-title":"Determinants of preterm birth at Jimma University Medical Center, southwest Ethiopia","volume":"9","author":"M Abaraya","year":"2018","journal-title":"Pediatric Health Med Ther"},{"issue":"1","key":"pone.0331223.ref013","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s12884-022-04404-9","article-title":"Trends in antenatal care visits and associated factors in Ghana from 2006 to 2018","volume":"22","author":"PA Duodu","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pone.0331223.ref014","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s12884-017-1232-9","article-title":"Specialist antenatal clinics for women at high risk of preterm birth: a systematic review of qualitative and quantitative research","volume":"17","author":"R Malouf","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"10","key":"pone.0331223.ref015","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0275933","article-title":"An assessment of the quality of antenatal care and pregnancy outcomes in a tertiary hospital in Ghana","volume":"17","author":"S Amponsah-Tabi","year":"2022","journal-title":"PLoS One"},{"issue":"1","key":"pone.0331223.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0246005","article-title":"Determinants of preterm survival in a tertiary hospital in Ghana: A ten-year review","volume":"16","author":"EK Agbeno","year":"2021","journal-title":"PLoS One"},{"key":"pone.0331223.ref017","doi-asserted-by":"crossref","first-page":"989020","DOI":"10.3389\/fgwh.2022.989020","article-title":"Causes, survival rates, and short-term outcomes of preterm births in a tertiary hospital in a low resource setting: An observational cohort study","volume":"3","author":"M Mocking","year":"2023","journal-title":"Front Glob Womens Health"},{"issue":"3","key":"pone.0331223.ref018","first-page":"154","article-title":"Incidence of preterm births in a referral teaching hospital in Ghana: What is the role of maternal age, parity, gravidity and stress during pregnancy?","volume":"15","author":"E Otieku","year":"2021","journal-title":"Afr J Child Health"},{"key":"pone.0331223.ref019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2022\/3955869","article-title":"Prevalence and Factors Associated with Low Birth Weight and Preterm Delivery in the Ho Municipality of Ghana","volume":"2022","author":"WK Axame","year":"2022","journal-title":"Adv Publ Health"},{"key":"pone.0331223.ref020","doi-asserted-by":"crossref","first-page":"801092","DOI":"10.3389\/fgwh.2022.801092","article-title":"Prevalence and Risk Factors of Preterm Birth Among Pregnant Women Admitted at the Labor Ward of the Komfo Anokye Teaching Hospital, Ghana","volume":"3","author":"EO Anto","year":"2022","journal-title":"Front Glob Womens Health"},{"issue":"12","key":"pone.0331223.ref021","article-title":"Stillbirth incidence and determinants in a tertiary health facility in the Volta Region of Ghana","volume":"18","author":"AK Dah","year":"2023","journal-title":"PLoS One"},{"issue":"10","key":"pone.0331223.ref022","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0223478","article-title":"Maternal and perinatal outcomes among women with hypertensive disorders in pregnancy in Kumasi, Ghana","volume":"14","author":"ET Dassah","year":"2019","journal-title":"PLoS One"},{"issue":"01","key":"pone.0331223.ref023","doi-asserted-by":"crossref","DOI":"10.26502\/ogr031","article-title":"Outcomes of Preterm Labor and Preterm Births: A Retrospective Cross-Sectional Analytical Study in a Nigerian Single Center Population","volume":"03","author":"B C Umeigbo","year":"2020","journal-title":"Obstet Gynecol Res"},{"issue":"1","key":"pone.0331223.ref024","doi-asserted-by":"crossref","first-page":"39","DOI":"10.4103\/jcn.JCN_94_18","article-title":"Characteristics and predictors of outcome of care of preterm newborns in resource constraints setting, Maiduguri, Northeastern Nigeria","volume":"8","author":"S Pius","year":"2019","journal-title":"J Clin Neonatol"},{"issue":"1","key":"pone.0331223.ref025","doi-asserted-by":"crossref","DOI":"10.4081\/pr.2010.e3","article-title":"Prevalence and determinants of pre-term deliveries in the University of Ilorin Teaching Hospital, Ilorin, Nigeria","volume":"2","author":"OA Mokuolu","year":"2010","journal-title":"Pediatr Rep"},{"issue":"3","key":"pone.0331223.ref026","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.4314\/ahs.v21i3.43","article-title":"Preterm birth and its associated factors in Ethiopia: a systematic review and meta-analysis","volume":"21","author":"FW Sendeku","year":"2021","journal-title":"Afr Health Sci"},{"issue":"1","key":"pone.0331223.ref027","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0245825","article-title":"Determinants of preterm birth among women delivered in public hospitals of Western Ethiopia, 2020: Unmatched case-control study","volume":"16","author":"M Abadiga","year":"2021","journal-title":"PLoS One"},{"issue":"1","key":"pone.0331223.ref028","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s12884-020-2731-7","article-title":"The use of specialised preterm birth clinics for women at high risk of spontaneous preterm birth: a systematic review","volume":"20","author":"L Dawes","year":"2020","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pone.0331223.ref029","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1186\/s12884-023-06120-4","article-title":"Risk factors associated with preterm birth among mothers delivered at Lira Regional Referral Hospital","volume":"23","author":"T Etil","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"pone.0331223.ref030","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1186\/s12884-022-05095-y","article-title":"Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study","volume":"22","author":"E Ayebare","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"issue":"2","key":"pone.0331223.ref031","doi-asserted-by":"crossref","first-page":"113","DOI":"10.20884\/1.bion.2020.2.2.48","article-title":"Risk Factors for Late- Preterm Infants in One Public Hospital at Banyumas District Indonesia","volume":"2","author":"H Purwandari","year":"2020","journal-title":"J Bionurs"},{"issue":"7","key":"pone.0331223.ref032","doi-asserted-by":"crossref","first-page":"3262","DOI":"10.18203\/2394-6040.ijcmph20212575","article-title":"Influence of maternal occupation on adverse pregnancy outcomes in a Nigerian tertiary health facility","volume":"8","author":"HO Nwoga","year":"2021","journal-title":"Int J Community Med Public Heal"},{"issue":"3","key":"pone.0331223.ref033","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1080\/17542863.2017.1364283","article-title":"Major depression in Cyprus amid financial crisis: prevalence and correlates","volume":"11","author":"M Economou","year":"2017","journal-title":"Int J Cult Ment Health"},{"issue":"1","key":"pone.0331223.ref034","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1186\/s12889-021-11113-z","article-title":"Determinants of adverse birth outcome in Sub-Saharan Africa: analysis of recent demographic and health surveys","volume":"21","author":"KS Tamirat","year":"2021","journal-title":"BMC Public Health"},{"issue":"1","key":"pone.0331223.ref035","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/ijgo.13857","article-title":"FIGO good practice recommendations on modifiable causes of iatrogenic preterm birth","volume":"155","author":"FIGO Working Group for Preterm Birth","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"key":"pone.0331223.ref036","doi-asserted-by":"crossref","first-page":"621382","DOI":"10.3389\/fimmu.2021.621382","article-title":"Poor Birth Outcomes in Malaria in Pregnancy: Recent Insights Into Mechanisms and Prevention Approaches","volume":"12","author":"CLL Chua","year":"2021","journal-title":"Front Immunol"},{"key":"pone.0331223.ref037","doi-asserted-by":"crossref","first-page":"20503121231199653","DOI":"10.1177\/20503121231199653","article-title":"Interventions for malaria prevention in pregnancy; factors influencing uptake and their effect on pregnancy outcomes among post-natal women in a tertiary facility in the Volta Region of Ghana","volume":"11","author":"GD Ampofo","year":"2023","journal-title":"SAGE Open Med"},{"issue":"6","key":"pone.0331223.ref038","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1001\/jama.2012.216231","article-title":"Intermittent preventive therapy for malaria during pregnancy using 2 vs 3 or more doses of sulfadoxine-pyrimethamine and risk of low birth weight in Africa: systematic review and meta-analysis","volume":"309","author":"K Kayentao","year":"2013","journal-title":"JAMA"},{"issue":"8","key":"pone.0331223.ref039","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-005877","article-title":"Effectiveness of intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) in Ghana","volume":"6","author":"DK Dosoo","year":"2021","journal-title":"BMJ Glob Health"},{"issue":"2","key":"pone.0331223.ref040","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-051675","article-title":"Determinants of antenatal care use in nine sub-Saharan African countries: a statistical analysis of cross-sectional data from Demographic and Health Surveys","volume":"12","author":"AK Andegiorgish","year":"2022","journal-title":"BMJ Open"},{"issue":"1","key":"pone.0331223.ref041","doi-asserted-by":"crossref","DOI":"10.1186\/s12936-022-04331-2","article-title":"Malaria in pregnancy control and pregnancy outcomes: a decade\u2019s overview using Ghana\u2019s DHIMS II data","volume":"21","author":"GD Ampofo","year":"2022","journal-title":"Malar J"},{"issue":"10","key":"pone.0331223.ref042","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0257666","article-title":"An ethnographic study of how health system, socio-cultural and individual factors influence uptake of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine in a Ghanaian context","volume":"16","author":"M Aberese-Ako","year":"2021","journal-title":"PLoS One"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0331223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T17:31:50Z","timestamp":1756402310000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0331223"}},"subtitle":[],"editor":[{"given":"Adaoha Pearl","family":"Agu","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":42,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0331223","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,28]]}}}