PAWLOS TEKIA2025-06-092025-01-28https://repository.mu.edu.et/handle/123456789/41710.82589/muir-34010.82589/muir-34010.82589/muir-34010.82589/muir-34010.82589/muir-340Preterm birth has been referring to as babies born alive before 37 weeks or before 259 days of gestation of pregnancy are completed. Preterm birth is the leading cause of infant morbidity and mortality throughout the world. the magnitude of PTB remains a major issue in most developing countries including Ethiopia. To assess the prevalence of spontaneous preterm birth and associated factors among women’s giving birth in Tigray region, North Ethiopia in 2024. A hospital-based cross-sectional study was undertaken from November to December 2024. A systematic sampling technique was used to select 325 mother. The data were collected using kobo toolbox by interviewing the mothers and reviewing their charts using a structured and pretested questionnaire. The outcome variable was spontaneous preterm birth. Data were export from Kobo Toolbox to Excel then to SSPS version 27. Then analyzed using SSPS version 27. Bivariate and multivariable logistic regression analyses were done to determine the risk factors associated with premature birth. Variables statistically significant in Bivariate analysis at p-value less than 0.25 were taken to the multivariable logistic regression. Multivariable logistic regression was done to identify the associated factors of spontaneous preterm birth at P-value < 0.05 were considered reliable for the analysis of this study. in this study, the prevalence of spontaneous preterm birth was 25.2 % (95% CI: 20.48, 29.92%). In multivariable logistic regression model; multiple gestation(AOR) =0.069: 95% CI 0.023–0.206), inadequate iron folate supplementation (AOR = 6.019% CI 1.568–23.105), PROM (AOR = 7.680: 95%CI 3.044–19.378), PIH (AOR = 3.554:95% CI 1.325–9.532), and UTI during pregnancy (AOR = 2.589: 95% CI 1.970–6.912) were significantly associated with preterm birth. The present study found that multiple gestation, inadequate iron folate supplementation, PROM, PIH and UTI during pregnancy were factors associated with preterm birth. Ensure that all pregnant women receive comprehensive ANC services with a focus on monitoring high risk pregnancy like multiple pregnancy, those with history of PROM, PIH, screening and treating infections such as UTI and providing adequate iron folate supplementation for at least three months during pregnancy is decisive.enspontaneous preterm birthTigray regionEthiopiaThesis