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To investigate time trends of preterm birth and estimate the contributions of risk factors to the changes in preterm birth rates over a decade (2009-2018) of transitional period in Shenzhen, China. Retrospective cohort study between 2009 and 2018. All births in Baoan during January 2009 and December 2018 registered in the Shenzhen Birth Registry Database. 478 044 live births were included with sociodemographic and medical records for both women and infants. The incidence rate of preterm birth stratified by different maternal and infant c