Preterm Birth: Prevalence, Risk factors, and Preventive recommendations in a Remote area of Mae Hong Son Province

Abstract

Preterm birth refers to delivery before 37completed weeks of gestation, is a major cause of mortality among children under five years old. It is a significant public health problem in Thailand and worldwide. It is the key priority issues driving the development of maternal and child health services in Mae Hong Son Province. As a remote border province where most of the population belongs to ethnic minority groups, limitations in economic, social, educational, and nutritional conditions, as well as restricted access to healthcare services, may contribute to increased risk of preterm birth. However, studies on preterm birth in Mae Hong Son Province or in similar contextual settings are limited. This article aims to review the definition, prevalence, risk factors associated with preterm birth, and preventive guideline through a literature of related studies both Thailand and abroad, to inform context-specific recommendations for the prevention and management of preterm birth in Mae Hong Son Province.

The review found that preterm birth results from multiple factors that stimulate uterine contractions. Factors associated with preterm birth include maternal factors such as young age, poor nutrition, risky behaviors, and obstetric risk history; family and educational status; cultural influences; remoteness and environmental pollution; and the quality of healthcare services. In Mae Hong Son Province, additional context-specific risks include adolescent pregnancy, undernutrition, previous preterm birth, exposure to PM 2.5 air pollution, and limited access to antenatal care services. Although Thailand has implemented national policies and guidelines for preterm birth prevention, addressing this issue in Mae Hong Son requires in-depth data analysis, evaluation of existing interventions, and the development of context-specific strategies. Strengthening provincial policy, strategic planning, and targeted interventions, along with collaboration among health systems, local networks, and communities under the 4P framework of Health Region 1, is essential to effectively reduce preterm birth in this setting.