Preterm Birth in the West Bank, Palestine: Insights From a Hospital-Based Cohort Study.

AIM: Preterm birth (PTB), delivery before 37 completed weeks of gestation, remains a major cause of neonatal morbidity and mortality. Evidence from conflict-affected, resource-limited settings such as the West Bank, Palestine, is limited. This study aimed to estimate PTB incidence and identify maternal, neonatal and socioeconomic risk factors using hospital-based data from government facilities.

METHODS

A retrospective cohort study utilised the Avicenna Health Information System across three major governmental hospitals in the West Bank. All live births at ≥ 24 weeks' gestation between January 2023 and May 2024 were included. Descriptive statistics, chi-square tests and multivariable logistic regression were applied to assess PTB-associated factors.

RESULTS

Among 18,760 live births, 1427 (7.6%) were preterm, mostly moderate to late preterm (7.0%). Higher PTB risk was observed among mothers aged < 20 years (aOR 1.53) or ≥ 35 years (aOR 1.32), male infants (aOR 1.16) and multiple pregnancies (twins aOR 4.98; triplets aOR 17.28). The Ramallah district had the highest PTB rate (aOR 2.35), likely reflecting referral to tertiary care.

CONCLUSION

PTB incidence was lower than previous national estimates but may underestimate community rates. Findings highlight key determinants and emphasise the need for improved data systems and population-based perinatal surveillance in Palestine.