Risk factors for spontaneous preterm birth in two urban areas of Ukraine

The economic, social and health problems faced by former eastern bloc count ries after the demise of the Soviet Union are unique in the recent history of Europe. We conducted a study in two urban areas of Ukraine, asking if th e traditional predictors of preterm delivery continue to be associated with risk under those conditions. Subjects were pregnant women with last menstr ual period (LMP) between 25 December 1992 and 23 July 1994. Self-completed questionnaires and the medical record provided data. We compared 137 sponta neous preterm deliveries with 2886 full-term births, using all established risk factors fur which we had data. Maternal age was the variable most stro ngly related to preterm birth. Being 18 or less had an odds ratio (OR) of 3 .7; being 30+ had an OR of 2.5 relative to the reference group of age 25-29 . Placental complications and pre-existing hypertension had ORs of 2.7 and 2.3, respectively, but the confidence interval included 1.0. Low net pregna ncy weight gain (less than 10 kg) was significantly associated with preterm birth, but the rate of net weight gain was not. Marital status and educati onal category were only weakly related. We conclude that although Ukraine f aced serious difficulties during its transition to a market Economy, these problems did not generally alter the outcome of pregnancy in our sample whe n the classic risk factors for preterm delivery were present.