Association between preterm births and socioeconomic development: analysis of national data

Marina Sanches Montemor; Gabriella Ferreira Demarque; Agatha Sacramento Rodrigues; Rossana Pulcinelli Vieira Francisco; Mario Henrique Burlacchini de Carvalho

doi:10.1186/s12889-022-14376-2

Association between preterm births and socioeconomic development: analysis of national data

BMC Public Health. 2022 Nov 3;22(1):2014. doi: 10.1186/s12889-022-14376-2.

Authors

Marina Sanches Montemor¹, Gabriella Ferreira Demarque², Agatha Sacramento Rodrigues³, Rossana Pulcinelli Vieira Francisco^{1

4}, Mario Henrique Burlacchini de Carvalho^{5

6}

Affiliations

¹ Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brasil.
² Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, Brasil.
³ Departamento de Estatística, Universidade Federal Do Espírito Santo, Vitória, Espírito Santo, Brasil.
⁴ Departamento de Obstetrícia E Ginecologia, Disciplina de Obstetrícia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brasil.
⁵ Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brasil. mario.burlacchini@hc.fm.usp.br.
⁶ Departamento de Obstetrícia E Ginecologia, Disciplina de Obstetrícia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brasil. mario.burlacchini@hc.fm.usp.br.

Abstract

Background: The increasing prevalence of preterm birth, which is a global phenomenon, is attributable to the increased medical indications, artificial gestations, and some socioeconomic factors. This study was conducted to identify whether development and equality indices are associated with the incidence of preterm birth, specifically, spontaneous and elective preterm births.

Methods: This retrospective observational study comprised an analysis of data on live births from 2019 in Brazil and on socioeconomic indices that were derived from census information in 2017. Data were summarised using absolute and relative frequencies. Spearman's correlation was used to determine the correlation between socioeconomic factors and the preterm birth rate. Multiple beta regression analysis was performed to determine the best model of socioeconomic covariates and preterm birth rate. The significance level was set at 5%.

Results: In 2019 in Brazil, the preterm birth rate was 11.03%, of which 58% and 42% were spontaneous and elective deliveries, respectively. For all preterm births, Spearman's correlation varied from ρ = 0.4 for the Gini Index and ρ = - 0.24 for illiteracy. The best fit modelled the spontaneous preterm birth fraction as a negative function of the Human Development Index (HDI). The best-fit model considered the expected elective preterm birth fraction as a positive function of the HDI and as a negative function of the Gini Index, which was used as a precision parameter.

Conclusions: We observed a reduction in the fraction of spontaneous preterm births; however, the distribution was not uniform in the territory: higher rates of spontaneous preterm birth were noticed in the north, northeast, and mid-west regions. Thus, areas with lower education levels and inequal income distribution have a higher proportion of spontaneous preterm birth. The fraction of elective preterm birth was positively associated with more advantaged indices of socioeconomic status.

Keywords: Elective preterm birth; Preterm birth; Socioeconomic status; Spontaneous preterm birth.

Publication types

Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Female
Humans
Income
Infant, Newborn
Pregnancy
Pregnancy, Multiple
Premature Birth* / epidemiology
Premature Birth* / etiology
Prevalence
Risk Factors
Socioeconomic Factors