<![CDATA[Background: Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide. Besides obstetric and maternal medical conditions, psychological factors, particularly maternal stress during pregnancy, may contribute to the risk of preterm birth through neuroendocrine mechanisms affecting pregnancy outcomes. This study aimed to examine the relationship between maternal stress levels and the risk of preterm birth among pregnant women at Maba Regional General Hospital, Maba District, East Halmahera Regency. Methods: This analytical observational study used a cross-sectional design and was conducted from March to May 2026. A total of 75 pregnant women were selected using total sampling. Maternal stress was assessed using the Perceived Stress Scale (PSS-10), while the risk of preterm birth was determined based on obstetric risk factors documented in medical records. Data were analysed using descriptive statistics and the Chi-square test with a 95% confidence level. Results: Most respondents experienced moderate stress (41.3%), while 26.7% experienced high stress. A high risk of preterm birth was identified in 38.7% of participants. Pregnant women with high stress levels were more likely to have a high risk of preterm birth. The Chi-square test showed a significant association between maternal stress level and preterm birth risk (p=0.001). Conclusion: Maternal stress during pregnancy was significantly associated with increased preterm birth risk. Integrating mental health screening, psychological counselling, and stress management into antenatal care may help reduce this risk and improve maternal and neonatal health outcomes]]>
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