Background: About 15 million babies are born prematurely in the world every year. The highest causes of neonatal death are due to premature birth in Ethiopia. To reduce the rate of preterm delivery by correcting modifiable or preventable causes, the availability of local data is important.

Objective: This study aimed to identify the determinants of preterm birth among women who gave birth in public Hospitals in North Shewa Zone central Ethiopia.

Methodology: An unmatched case-control study was conducted at public hospitals in the North Shoa zone. Data were collected by a structured questionnaire and entered into EPI INFO 7, transferred to SPSS 23 for analysis. Descriptive statistics such as tables, graphs, and proportions were used to present data. Binary and multiple logistic regression analyses were computed to identify determinants of preterm birth. Adjusted Odds Ratio (AOR), 95% Confidence Interval (CI), and p-value < 0.05 were computed to determine the presence of an association between dependent and independent variables.

Result: Unable to get nutritional counseling(AOR=2.2, 95% CI:1.1, 4.62), food taboo (AOR=3.05, 95% CI:1.56, 5.96) , not taking dark green leafy vegetables (DGLV), (AOR=3.3, 95% CI:1.2, 9.17), previous history of adverse birth outcomes (AOR=3.29, 95% CI:1.38,7.88), previous history of preterm birth(PTB)(AOR=2.1, 95% CI:1.03, 4.2),wanted but not planned pregnancy (AOR=2.62, 95% CI:1.34,5.13),neither wanted nor planned pregnancy(AOR=4.22, 95% CI: 1.78, 10.04),medical illness (AOR=2.88, 95% CI: 1.24, 6.73), obstetrics complications(AOR=6.44, 95% CI:3.61, 11.50), smoking cigarette (AOR=3.91, 95% CI:1.15, 13.34),  alcohol drinking (AOR=2.16, 95% CI: 1.2, 3.89),  anemia(AOR=2.78, 95% CI:1.48, 5.22),and MUAC < 23 cm (AOR=3.7, 95% CI:2.1, 6.56) were associated  with preterm birth.

Conclusions: -Nutritional counseling, food taboo, DGLV, previous history of adverse outcome and PTB, pregnancy status, obstetric complications, medical illness, anemia, MUAC, smoking cigarettes, and drinking alcohol were identified determinants of preterm birth in the study area. Encouraging women to eat varieties of diets like DGLV and fruits during pregnancy. Adhering to culturally appropriate nutrition education and encouraging women to stop cigarette smoking.

Keywords: Determinants, North Shewa, preterm birth, Public hospitals