Socioeconomic inequalities in very preterm birth rates
Socioeconomic inequalities in very preterm birth rates
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DOI：
10.1136/adc.2005.090308
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发表时间：
2007-01-01
影响因子：
4.4
通讯作者：
Field, D. J.
中科院分区：
文献类型：
--
作者：
Smith, L. K.;Draper, E. S.;Field, D. J.
目的：调查近十年来社会经济不平等对极早产发生率的影响。方法：对 1994 年 1 月 1 日至 2003 年 12 月 31 日期间英国前特伦特卫生区所有 5,49 618 例出生的婴儿进行生态学研究。从人口调查中确定了妊娠 22(+0) 至 32(+6) 周的所有单胎出生（7 185 例出生）新生儿服务和死产。使用泊松回归，按出生年份和剥夺十分位（多重剥夺指数的儿童贫困部分）计算极早产（22-32周）和极早产（22-28周）的发生率。结果：极早产单胎的发生率从1994年的每1000名新生儿11.9例上升到2003年的每1000名新生儿13.7例。与来自最贫困十分之一的婴儿相比，来自最贫困十分之一的婴儿的严重早产风险几乎是来自最贫困十分之一的婴儿的两倍，其中最贫困十分之一的每 1000 名新生儿中有 16.4 例早产，而最贫困的十分之一的每 1000 名新生儿中有 8.5 例早产（发生率比 1.94；95% Cl（1.73 至 2.17））。这种剥夺差距在整个十年期间保持不变。极早产的社会经济不平等程度与极早产相同（22-28 周发病率比 1.94；95% Cl（1.62 至 2.32））。结论：这个庞大而独特的极早产数据集显示了随着时间的推移持续存在的广泛社会经济不平等。这些发现可能会对长期发病率的负担产生影响。我们的研究可以帮助未来的医疗保健规划、社会经济不平等的监测以及干预措施的针对性，以缩小这种持续存在的贫困差距。
Aims: To investigate the extent of socioeconomic inequalities in the incidence of very preterm birth over the post decade.Methods: Ecological study of all 5,49 618 births in the former Trent health region, UK, from 1 January 1994 to 31 December 2003. All singleton births of 22(+0) to 32(+6) weeks gestation (7 185 births) were identified from population surveys of neonatal services and stillbirths. Poisson regression was used to calculate incidence of very preterm birth (22-32 weeks) and extremely preterm birth (22-28 weeks) by year of birth and decile of deprivation (child poverty section of the Index of Multiple Deprivation).Results: Incidence of very preterm singleton birth rose from 11.9 per 1000 births in 1994 to 13.7 per 1000 births in 2003. Those from the most deprived decile were at nearly twice the risk of very preterm birth compared with those from the least deprived decile, with 16.4 per 1000 births in the most deprived decile compared with 8.5 per 1000 births in the least deprived decile (incidence rate ratio 1.94; 95% Cl (1.73 to 2.17)). This deprivation gap remained unchanged throughout the 10-year period. The magnitude of socioeconomic inequalities was the same for extremely preterm births (22-28 weeks incidence rate ratio 1.94; 95% Cl (1.62 to 2.32)).Conclusions: This large, unique dataset of very preterm births shows wide socio-economic inequalities that persist over time. These findings are likely to have consequences on the burden of long-term morbidity. Our research can assist future healthcare planning, the monitoring of socio-economic inequalities and the targeting of interventions in order to reduce this persistent deprivation gap.