Abstract
<title>Abstract</title> <p> <bold>Background</bold> Preterm birth remains a significant public health issue worldwide. It accounts about a million neonatal deaths and is the second cause of both neonatal and under-five child mortality. Neonatal mortality accounts around half of under-five child mortality in Ethiopia. In low-income countries, such as Ethiopia, where access to quality antenatal care and skilled birth attendance is limited, preterm birth is a major contributor to neonatal morbidity and mortality. Despite its immense consequences, there is limited research available on preterm birth and associated factors in Ethiopian public hospitals. <bold>Methods</bold> Facility based cross sectional study was carried out in four public hospitals of Addis Ababa using Systematic sampling method to include 316 women who had given birth at four Hospitals from August 1 to 30, 2024. Data was collected using a structured face-to-face interview questionnaire and was entered into epi data 3.1, then it was analyzed by Statistical Package for Social Science (SPSS) Versions 25. Descriptive statistics such as frequency, percentage, means and standard deviation were employed to summarize the data and Bi-variable and multivariable analysis were performed using logistic regression model to identify factors for preterm birth. Statistical significance was declared at p-value < 0.05. <bold>Result</bold> Fifty six (17.7%) with 95% CI (13.88, 21.52) mothers had a preterm birth. Premature rupture of membrane (AOR = 4.26; 95% CI 1.94, 6.8), Ante-partum hemorrhage (AOR = 3.23, 95% CI (2.61, 6.87), Pregnancy induced hypertension (AOR = 6.46, 95% CI (3.12, 14.17), and Urinary tract infection (AOR=4.71, 95% CI (3.08, 7.82) were found to be significantly associated with preterm birth. <bold/> <bold>Conclusion</bold> The magnitude of PTB was high as nearly one out of six of women giving birth prematurely; stakeholders need to develop interventions that consider all the risk factors for PTB. </p>