Publication:

Association between maternal psychosocial factors and preterm birth: a case-control study from central Uttar Pradesh, India

Background Maternal psychosocial factors during pregnancy have been associated with an increased risk of preterm birth (PTB), but evidence from rural Indian settings remains limited. This study examined the relationship between maternal psychosocial factors and PTB in rural Uttar Pradesh, India.

Methods A case–control study was conducted in Raebareli district, Uttar Pradesh, among 425 postpartum women interviewed within three months of delivery. Cases included 110 women who delivered preterm infants (<37 weeks of gestation), while controls comprised 315 women who delivered at term (≥37 weeks).

Results Persistent depressive symptoms during pregnancy were reported by nearly half of the women and were more common among cases than controls (65.5% vs 45.0%). After adjusting for potential confounders, maternal depressive symptoms were significantly associated with increased odds of PTB (AOR=3.09). A history of mental health problems (AOR=1.69), physical abuse by a partner during pregnancy (AOR=2.03), and substance use (AOR=2.41) were also independently associated with higher odds of PTB. In contrast, strong family support (AOR=0.55) and a caring, emotionally supportive spousal relationship (AOR=0.42) were protective against PTB.

Conclusions Maternal psychosocial factors play a critical role in the risk of PTB in rural India. Integrating mental health screening, psychosocial risk assessment, and interventions addressing domestic violence and substance use into routine antenatal care, alongside efforts to strengthen family and spousal support, may be essential for reducing the burden of PTB.