Effects of socioeconomic position and clinical risk factors on spontaneous and iatrogenic preterm birth.
Effects of socioeconomic position and clinical risk factors on spontaneous and iatrogenic preterm birth.
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DOI：
10.1186/1471-2393-14-117
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发表时间：
2014-03-27
影响因子：
3.1
通讯作者：
Allen AC
中科院分区：
文献类型：
--
作者：
Joseph KS;Fahey J;Shankardass K;Allen VM;O'Campo P;Dodds L;Liston RM;Allen AC
文献显示，社会经济地位和早产之间的关系变量和不一致。我们研究了自发性和医源性早产的危险因素，重点是社会经济地位和临床危险因素，以解释观察到的不一致性。我们对1988年至2003年新斯科舍省所有单胎分娩的患者进行了一项回顾性人群队列研究。数据来自新斯科舍省Atlee围产期数据库和联邦所得税T1家庭档案。采用单独的逻辑模型来量化社会经济地位、临床危险因素与自发性早产和医源性早产之间的关系。研究人群包括132，714例单胎分娩，早产率为5.5%。最低（与最高）家庭收入组的自发性早产率（率比1.14，95%置信区间（CI）1.03，1.25）显著较高，但医源性早产率（率比0.95，95% CI 0.75，1.19）无显著差异。调整母亲特征减弱了家庭收入与自发性早产的关系，但加强了与医源性早产的关系。高血压等临床危险因素与自发性高血压的发生有差异。（率比3.92，95% CI 3.47，4.44）和医源性早产（率比14.1，95% CI 11.4，17.4），但糖尿病等因素不是（自发性早产率比为4.38，95% CI 3.21，5.99，医源性早产率比为4.02，95% CI 2.07，7.80）。社会经济地位和临床危险因素对自发性和医源性早产的影响不同。医源性早产的最近时间增加似乎是负责社会经济地位和早产之间的关系不一致。
The literature shows a variable and inconsistent relationship between socioeconomic position and preterm birth. We examined risk factors for spontaneous and iatrogenic preterm birth, with a focus on socioeconomic position and clinical risk factors, in order to explain the observed inconsistency. We carried out a retrospective population-based cohort study of all singleton deliveries in Nova Scotia from 1988 to 2003. Data were obtained from the Nova Scotia Atlee Perinatal Database and the federal income tax T1 Family Files. Separate logistic models were used to quantify the association between socioeconomic position, clinical risk factors and spontaneous preterm birth and iatrogenic preterm birth. The study population included 132,714 singleton deliveries and the rate of preterm birth was 5.5%. Preterm birth rates were significantly higher among the women in the lowest (versus the highest) family income group for spontaneous (rate ratio 1.14, 95% confidence interval (CI) 1.03, 1.25) but not iatrogenic preterm birth (rate ratio 0.95, 95% CI 0.75, 1.19). Adjustment for maternal characteristics attenuated the family income-spontaneous preterm birth relationship but strengthened the relationship with iatrogenic preterm birth. Clinical risk factors such as hypertension were differentially associated with spontaneous (rate ratio 3.92, 95% CI 3.47, 4.44) and iatrogenic preterm (rate ratio 14.1, 95% CI 11.4, 17.4) but factors such as diabetes mellitus were not (rate ratio 4.38, 95% CI 3.21, 5.99 for spontaneous and 4.02, 95% CI 2.07, 7.80 for iatrogenic preterm birth). Socioeconomic position and clinical risk factors have different effects on spontaneous and iatrogenic preterm. Recent temporal increases in iatrogenic preterm birth appear to be responsible for the inconsistent relationship between socioeconomic position and preterm birth.
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DOI：
10.1016/s1701-2163(16)34173-1
发表时间：
2009-05-01
影响因子：
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