Association between preterm birth and its subtypes and maternal sociodemographic characteristics during the post-transitional phase in a developing country with a very high human development index

Abstract Objectives Chile is a post-transitional country evolving towards a stationary population pyramid, which may be associated with increasing preterm birth (PTB) rates. This study aimed to compare maternal sociodemographic characteristics between the start of the post-transition phase (1994) an...

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Bibliographic Details
Published in:Public health (London) 2017-06, Vol.147, p.39-46
Main Authors: Araya, B.M, Díaz, M, Paredes, D, Ortiz, J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
Birth
Birth records
Childbirth & labor
Childrens health
Chile - epidemiology
Cohort Studies
Design analysis
Developing Countries
Education
Employment
Extremely premature infant
Female
Fetuses
Gestation
Gestational age
Health transition
Human development
Humans
Infant, Newborn
Infectious Disease
Internal Medicine
LDCs
Low level
Marital status
Maternal characteristics
Mothers - statistics & numerical data
Phase transitions
Population characteristics
Pregnancy
Premature birth
Premature Birth - epidemiology
Premature labor
Prenatal development
Preterm birth
Prevalence
Regression analysis
Regression models
Residence
Risk analysis
Risk Factors
Sociodemographics
Socioeconomic Factors
Stationary population
Subtypes
Triplets
Twins
Variables
Working mothers
Young Adult
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Summary:Abstract Objectives Chile is a post-transitional country evolving towards a stationary population pyramid, which may be associated with increasing preterm birth (PTB) rates. This study aimed to compare maternal sociodemographic characteristics between the start of the post-transition phase (1994) and an established stage (2013) and to evaluate associations between these characteristics and PTB. Study design An observational analytic design was conducted using national birth records ( n  = 4,956,311). Methods Variables analysed in the 20 birth cohorts from 1994 to 2013 were: length of gestation (preterm 35 years); education level (12 years of education); employment; marital status; area of residence; and type of birth (singleton, twins, and triplets or higher order). The prevalence of PTB was expressed as a percentage, and associations between PTB and predictor variables were analysed using logistic regression models. Results Education level, age >35 years, maternal employment, unmarried status, twin delivery and urban residency rates increased between 1994 and 2013. According to the adjusted models, age >35 years and delivery of more than two foetuses were risk factors for all PTB subtypes. Maternal employment was a risk factor for moderate/severe, late and total PTB, and a low level of education was a risk factor for late and total PTB. On the other hand, age ≤19 years was protective against all PTB subtypes. Conclusions All maternal characteristics changed between 1994 and 2013. Furthermore, the prevalence of PTB increased for all predictor variables studied over this period.
ISSN:0033-3506
1476-5616
DOI:10.1016/j.puhe.2017.01.027