General Background: Preterm birth remains a major global obstetric concern and a leading contributor to neonatal morbidity and mortality, particularly in low- and middle-income countries. Specific Background: In Mosul maternity hospitals, maternal health conditions and obstetric characteristics may contribute to variations in gestational age and neonatal birth weight. Knowledge Gap: Limited local evidence exists regarding the association between maternal risk factors and neonatal outcomes among women delivering preterm in Mosul city hospitals. Aims: This study aimed to describe maternal characteristics, identify risk factors of preterm birth, and determine the relationship between these factors, gestational age at birth, and neonatal birth weight. Results: In a cross-sectional sample of 234 women, the mean gestational age was 31.42 weeks and the mean interpregnancy interval was 17.88 months. Excessive uterine activity (82.1%), vaginal infection (65.0%), and urinary and genital tract infections (59.0%) were the most prevalent conditions. Statistical analysis demonstrated highly significant associations between maternal risk factors and both gestational age and birth weight (p<0.05). Short interpregnancy intervals were significantly related to lower gestational age categories and increased proportions of low, very low, and extremely low birth weight neonates. Novelty: This study provides hospital-based empirical evidence from Mosul linking specific maternal conditions and birth spacing patterns with prematurity outcomes. Implications: Routine infection screening, management of uterine activity, and counseling on appropriate birth spacing are essential strategies to reduce adverse neonatal outcomes in maternity care settings. Keywords: Preterm Birth, Maternal Risk Factors, Interpregnancy Interval, Neonatal Outcomes, Birth Weight Key Findings Highlights: Excessive contractions and reproductive tract infections were highly prevalent among participants. Significant statistical relationships were identified between maternal conditions and newborn measurements. Short birth spacing corresponded with higher proportions of very early delivery and reduced neonatal mass.
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