Maternal and obstetric determinants of prematurity and term low birth weight in Afghanistan: a hospital-based case-control study.

Authors

Nasar Ahmad Shayan, Ali Rahimi, Tulin Coban, Lailoma Laila Arab, Hilal Özcebe

Published in

Scientific reports. Jun 24, 2026. Epub Jun 24, 2026.

Abstract

Prematurity and term low birth weight (LBW) are important contributors to neonatal morbidity and mortality in Afghanistan. Evidence from hospital-based studies in Herat remains limited, particularly studies that distinguish prematurity from term LBW. This study aimed to identify maternal, socioeconomic, obstetric, and pregnancy-related factors associated with prematurity and term LBW among newborns delivered in Herat, western Afghanistan. An unmatched hospital-based case-control study was conducted at Herat Midwifery Hospital from June 15 to September 15, 2023. The study included 176 premature infants, 84 term LBW infants, and 290 full-term normal-birth-weight controls. Prematurity was defined as birth before 37 completed weeks of gestation, and term LBW was defined as birth at ≥ 37 completed weeks with birth weight < 2500 g. Data were collected from hospital records and maternal interviews. Separate adjusted binary logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for prematurity and term LBW compared with full-term normal-birth-weight controls. Statistical significance was set at p < 0.05. Prematurity was associated with medium perceived economic status (OR = 2.21, 95% CI: 1.04-4.73), bad perceived economic status (OR = 5.16, 95% CI: 2.06-12.91), preeclampsia (OR = 5.98, 95% CI: 1.72-20.76), pregnancy-related health problems (OR = 13.76, 95% CI: 5.32-35.61), substance use during pregnancy (OR = 2.88, 95% CI: 1.11-7.45), and cesarean section (OR = 3.37, 95% CI: 1.99-5.73). Term LBW was associated with medium perceived economic status (OR = 3.98, 95% CI: 1.29-12.30), bad perceived economic status (OR = 19.62, 95% CI: 5.09-75.63), pregnancy-related health problems (OR = 8.88, 95% CI: 2.46-32.02), and cesarean section (OR = 9.76, 95% CI: 4.85-19.65). Poor perceived economic status and pregnancy-related health problems were associated with both prematurity and term LBW. Preeclampsia and substance use were associated mainly with prematurity. Cesarean section should be interpreted as a marker of high-risk obstetric conditions rather than as a direct causal factor. These findings support strengthening antenatal risk detection, management of pregnancy complications, and targeted maternal health interventions in Herat.

PMID:
42342870
Bibliographic data and abstract were imported from PubMed on 25 Jun 2026.

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