Sociodemographic characteristics of mother’s population and risk of preterm birth in Chile

Reproductive Health

Gérard Bréart²  Paulina O López¹ 

[1] Universidad de Valparaíso, Escuela de Obstetricia y Puericultura, Valparaíso, Chile;Université Pierre et Marie Curie, UMR S 953, Paris F-75005, France

关键词: Sociodemographic characteristics;    Risk factor;    Maternal population;    Preterm birth;   

Others  :  811596
DOI  :  10.1186/1742-4755-10-26

 received in 2013-01-02, accepted in 2013-05-03,  发布年份 2013

【 摘 要 】

Background

Preterm birth is a global problem in Perinatal and infant Health. Currently is gaining a growing attention. Rates of preterm birth have increased in most countries, producing a dramatic impact on public health. Factors of diverse nature have been associated to these trends.

In Chile, preterm birth has increased since 90. Simultaneously, the advanced demographic transition has modified the characteristics of woman population related to maternity.

The principal objective of this study is to analyze some sociodemographic characteristics of the maternal population over time, and their possible association to rates of preterm birth. The second aim is to identify groups of mothers at high risk of having a preterm child.

Methods

This population-based study examined all liveborn singletons in Chile from 1991 to 2008; divided in three periods. Preterm birth rates were measured as % births <37 weeks of gestation.

Logistic regression assessed the risk of preterm birth associated with mother’s age, parity, and marital status, expressed as crude and adjusted odds ratios.

Results

Over time, rates of preterm birth increased in overall population, especially during the third period (2001–2008). In the same time, characteristics of maternal population changed: significant increase of extreme reproductive ages, significant decrease in parity and increase in mothers living without a partner.

Risk of preterm birth remained higher in groups of mothers: <18 and >38 years of age; without a partner; primiparas and grandmultiparas. However, global increase in preterm birth was not explained by the modification of socio demographics characteristics of maternal population.

Conclusions

Some socio demographic characteristics remained associated with preterm birth over time. These associations allowed identifying five groups of mothers at higher risk to have a preterm child in the population.

Increase in overall preterm birth affected all women, even those considered at “low sociodemographic risk” and the contribution of more recent period (2001–2008) to this increase is greater.

Then, studied factors couldn’t explain the increase in preterm birth. Further research will have to consider other factors affecting maternal population that could explain the observed trend of preterm birth.

【 授权许可】

   
2013 López and Bréart; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, Rubens C, Menon R, Van Look PF: The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ 2009, 88:31-38.
• [2]Lawn JE, Kerber K, Enweronu-Laryea C, Cousens S: 3.6 million neonatal deaths--what is progressing and what is not? Semin Perinatol 2010, 34:371-386.
• [3]Lawn JE, Gravett MG, Nunes TM, Rubens CE, Stanton C: Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data. BMC Pregnancy Childbirth 2010, 10(Suppl 1):S1. BioMed Central Full Text
• [4]Simmons LE, Rubens CE, Darmstadt GL, Gravett MG: Preventing preterm birth and neonatal mortality: exploring the epidemiology, causes, and interventions. Semin Perinatol 2010, 34:408-415.
• [5]Howson CP, Kinney MV, Lawn JE: Born too soon: the global action report on preterm birth. Geneva: World Health Organization; 2012.
• [6]Goldenberg RL, Culhane JF, Iams JD, Romero R: Epidemiology and causes of preterm birth. Lancet 2008, 371:75-84.
• [7]Schempf AH, Branum AM, Lukacs SL, Schoendorf KC: Maternal age and parity-associated risks of preterm birth: differences by race/ethnicity. Paediatr Perinat Epidemiol 2007, 21:34-43.
• [8]OECD Reviews of Labour Market and Social Policies: Chile. http://www.oecd.org/fr/chili/publicationsdocuments/reports/ webcite
• [9]I.N.E: Maternidad: tendencias y variables influyentes. Santiago: Instituto Nacional de Estadísticas; 2007. mayo 2007
• [10]I.N.E: Fecundidad en Chile, situación reciente. Santiago: Instituto Nacional de Estadisticas diciembre; 2006.
• [11]Glinianaia SV, Rankin J, Pless-Mulloli T, Pearce MS, Charlton M, Parker L: Temporal changes in key maternal and fetal factors affecting birth outcomes: a 32-year population-based study in an industrial city. BMC Pregnancy Childbirth 2008, 8:39. BioMed Central Full Text
• [12]Joseph KS, Fahey J, Dendukuri N, Allen VM, O’Campo P, Dodds L, Liston RM, Allen AC: Recent changes in maternal characteristics by socioeconomic status. J Obstet Gynaecol Can 2009, 31:422-433.
• [13]Blondel B, Supernant K, Du Mazaubrun C, Breart G: Trends in perinatal health in metropolitan France between 1995 and 2003: results from the National Perinatal Surveys. J Gynecol Obstet Biol Reprod (Paris) 2006, 35:373-387.
• [14]Blondel B, Lelong N, Kermarrec M, Goffinet F: Trends in perinatal health in France between 1995 and 2010: Results from the National Perinatal Surveys. J Gynecol Obstet Biol Reprod (Paris) 2012, 41:151-166.
• [15]Olsen P, Laara E, Rantakallio P, Jarvelin MR, Sarpola A, Hartikainen AL: Epidemiology of preterm delivery in two birth cohorts with an interval of 20 years. Am J Epidemiol 1995, 142:1184-1193.
• [16]Jacobsson B, Ladfors L, Milsom I: Advanced maternal age and adverse perinatal outcome. Obstet Gynecol 2004, 104:727-733.
• [17]López OP, Bréart G: Trends in gestational age and birth weight in Chile, 1991–2008. A descriptive epidemiological study. BMC Pregnancy Childbirth 2012, 12:121. BioMed Central Full Text
• [18]Albala C, Vio F: Epidemiological transition in Latin America: The case of Chile. Public Health 1995, 109:431-442.
• [19]PAHO: Health situation in the Americas. Basic indicators Washington DC: Regional office of de World health organization; 2007.
• [20]DEIS. http://www.deis.minsal.cl webcite
• [21]WHO: International Statistical Classification of Diseases and Related Health Problems. 10th revision. Geneva: Word Health Organization; 1992.
• [22]WHO: Use and interpretation of anthropometric indicators of nutritional status. In vol. 64. Geneva: World Health Organization; 1986:929-941.
• [23]Platt RW, Abrahamowicz M, Kramer MS, Joseph KS, Mery L, Blondel B, Breart G, Wen SW: Detecting and eliminating erroneous gestational ages: a normal mixture model. Stat Med 2001, 20:3491-3503.
• [24]Joseph KS, Kramer MS, Allen AC, Mery LS, Platt RW, Wen SW: Implausible birth weight for gestational age. Am J Epidemiol 2001, 153:110-113.
• [25]McMahon CA, Gibson FL, Allen JL, Saunders D: Psychosocial adjustment during pregnancy for older couples conceiving through assisted reproductive technology. Hum Reprod 2007, 22:1168-1174.
• [26]Schonhaut BL, P RM, Astudillo DJ: Prematuros tardíos: un grupo de riesgo de morbilidad a corto y largo plazo. Rev ChilPediatr 2012, 83:217-223.
• [27]Zhang J, Yu KF: What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 1998, 280:1690-1691.
• [28]Platt RW: Logistic regression and odds ratios. Inj Prev 1997, 3:294.
• [29]Vargas NA, Villar C, Lastra A: [Change in reproductive partner among women delivering at a Metropolitan Santiago public hospital]. Rev Med Chil 2004, 132:719-724.
• [30]Gibbons L, Belizan JM, Lauer JA, Betran AP, Merialdi M, Althabe F: Inequities in the use of cesarean section deliveries in the world. Am J Obstet Gynecol 2012, 206:331. e331-319
• [31]Menacker F, Declercq E, Macdorman MF: Cesarean delivery: background, trends, and epidemiology. Semin Perinatol 2006, 30:235-241.
• [32]Barros FC, Velez Mdel P: Temporal trends of preterm birth subtypes and neonatal outcomes. Obstet Gynecol 2006, 107:1035-1041.
• [33]Parker JD, Schoendorf KC: Implications of cleaning gestational age data. Paediatr Perinat Epidemiol 2002, 16:181-187.
• [34]Arbuckle TE, Wilkins R, Sherman GJ: Birth weight percentiles by gestational age in Canada. Obstet Gynecol 1993, 81:39-48.
• [35]Foix-L’Helias L, Blondel B: Changes in risk factors of preterm delivery in France between 1981 and 1995. Paediatr Perinat Epidemiol 2000, 14:314-323.
• [36]Keirse MJ, Hanssens M, Devlieger H: Trends in preterm births in Flanders, Belgium, from 1991 to 2002. Paediatr Perinat Epidemiol 2009, 23:522-532.
• [37]Haas JS, Jackson RA, Fuentes-Afflick E, Stewart AL, Dean ML, Brawarsky P, Escobar GJ: Changes in the health status of women during and after pregnancy. J Gen Intern Med 2005, 20:45-51.
• [38]Molina R, Molina T, González E: Madres niñas-adolescentes de 14 años y menos: Un grave problema de salud pública no resuelto en Chile. Rev Med Chil 2007, 135:79-86.
• [39]Raatikainen K, Heiskanen N, Verkasalo PK, Heinonen S: Good outcome of teenage pregnancies in high-quality maternity care. Eur J Public Health 2006, 16:157-161.
• [40]Joseph KS, Young DC, Dodds L, O’Connell CM, Allen VM, Chandra S, Allen AC: Changes in maternal characteristics and obstetric practice and recent increases in primary cesarean delivery. Obstet Gynecol 2003, 102:791-800.
• [41]Donoso E: Descenso de la natalidad en Chile, un problema pais. Rev Chil Obstet Ginecol 2007, 72:73-75.
• [42]20 Años de Reproducción Asistida en Chile 1990–2009. http://www.socmer.cl/registro-chileno-1990-2009.pdf webcite
• [43]Raatikainen K, Heiskanen N, Heinonen S: Marriage still protects pregnancy. BJOG 2005, 112:1411-1416.
• [44]Shah PS, Zao J, Ali S: Maternal marital status and birth outcomes: a systematic review and meta-analyses. Matern Child Health J 2011, 15:1097-1109.