Prevalence and neonatal morbidities associated with preterm birth: A three-year retrospective study at Ekiti State University Teaching Hospital, Nigeria

• A three-year retrospective analysis of deliveries showed a decrease in preterm birth prevalence over the period, suggesting potential improvements in maternal care. • Preterm infants experienced significant complications, including jaundice, fever, anemia, convulsions, sepsis, birth defects, trauma, and hypoglycemia. • Maternal key contributors to preterm births included previous preterm delivery, prior cesarean section, pregnancy-induced hypertension, pre-eclampsia, and multiparity. • The study calls for enhancing antenatal care access, addressing identified risk factors, and implementing long-term follow-up for preterm infants to reduce mortality and morbidity in Nigeria. . Preterm delivery represents a critical public health challenge as the primary cause of infant mortality and significant morbidity among survivors. This retrospective study examined preterm birth prevalence and associated complications at Ekiti State University Teaching Hospital, Nigeria. Medical records of pregnant women receiving antenatal care and delivering between 2019-2021 were analyzed. Data included maternal characteristics, obstetric history, and neonatal outcomes, with descriptive statistics used for analysis. To assess the significance of the associations, between categorical variables, inferential statistical analyses were conducted using Chi-square test. The statistical significance was set at p < 0.05. The distribution of neonatal morbidities across selected maternal demographic variables showed significant variation by year of delivery (p < 0.05), with higher prevalence among married women, Christians, and parents with tertiary education (p < 0.05). Preterm birth prevalence declined significantly over the years: 20.9% in 2019, 10.2% in 2020, and 8.2% in 2021 (χ² = 30.42, p < 0.001), indicating a downward trend and a corresponding increase in term deliveries. Maternal factors significantly associated with preterm birth included parity (p < 0.001), gestational age at booking (p = 0.042), previous cesarean section (p = 0.029), history of pregnancy-induced hypertension (p < 0.001), antepartum hemorrhage (p < 0.001), pre-eclampsia (p < 0.001), and eclampsia (p < 0.001). Most cases occurred among multiparous women (parity 1–4), those booking at ≤20 weeks gestation, and those with histories of pregnancy-induced hypertension or pre-eclampsia. Neonatal variables showed significant variations by year in birth weight (χ² = 180.32, p < 0.001) and mode of delivery (χ² = 282.28, p < 0.001), but not in sex (p = 0.999) or gestation type (p = 0.693). All reported morbidities (jaundice, fever, anemia, convulsion, and birth defects) were significantly associated with preterm birth (p < 0.05), with higher prevalence in these conditions. Preterm birth prevalence declined significantly from 2019 to 2021, alongside variations in neonatal morbidities influenced by maternal demographics and obstetric factors. Targeted interventions addressing modifiable risk factors, such as early booking and management of hypertensive disorders, could further reduce preterm births and associated morbidities in similar settings.