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American Journal of Epidemiology Vol. 149, No. 10: 908-915
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health
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Social differences of Very Preterm Birth in Europe: Interaction with Obstetric History
1Unité de Recherches Epidémiologiques sur la Santé des Femmes et des Enfants (INSERM, Unité 149) Villejuif, France
2Institute of Obstetrics and Gynecology, University of Perugia Perugia, Italy
3Université René Descartes, Service de Gynécologie Obstétrique de Port-Royal 123 boulevard Port-Royal, Paris, France
Social differences of very preterm birth (2232 completed weeks of amenorrhea) were studied using data from a large case-control survey in Europe between 1994 and 1997; 1, 675 very preterm births and 7, 965 full-term births were included. The relation between social factors and very preterm birth was studied according to obstetric history and the mode of delivery onset. Very preterm birth was significantly related to low educational level among women with no previous adverse pregnancy outcome (odds ratio (OR) = 2.67, 95 percent confidence interval (Cl) 1.664.28) and among primigravid women and those with previous first-trimester abortion (OR = 2.01, 95 percent Cl 1.562.58). In this group, unemployment of all household members was associated with a double risk of very preterm birth. No significant association between very preterm birth and socioeconomic status was observed among women with previous second-trimester abortion or preterm birth. Socioeconomic indicators remained significantly associated with both spontaneous and induced very preterm births among women with no previous late fetal loss or preterm birth. The results are consistent with social factors affecting the risk of very preterm birth, but the relation differs according to obstetric history. Am J Epidemiol 1999; 149: 90815.
education; infant; pregnancy; socioeconomic factors
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