ORIGINAL ARTICLE

Socioeconomic inequalities in very preterm birth rates

L K Smith¹, E S Draper¹, B N Manktelow¹, J S Dorling² and D J Field²

¹ Department of Health Sciences, University of Leicester, Leicester, UK
² Department of Health Sciences, University of Leicester, Neonatal Unit, Leicester Royal Infirmary, Leicester, UK

Correspondence to:
Correspondence to:
Lucy K Smith
Department of Health Sciences, University of Leicester, 22–28 Princess Road West, Leicester LE1 6TP, UK; lks1{at}le.ac.uk

Aims: To investigate the extent of socioeconomic inequalities in the incidence of very preterm birth over the past decade.

Methods: Ecological study of all 549 618 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% CI (1.73 to 2.17)). This deprivation gap remained unchanged throughout the 10-year period. The magnitude of socio-economic inequalities was the same for extremely preterm births (22–28 weeks incidence rate ratio 1.94; 95% CI (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.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Fantoms

Ben Stenson
Arch. Dis. Child. Fetal Neonatal Ed. 2007 92: F1. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Jansen, P W, Tiemeier, H, Jaddoe, V W V, Hofman, A, Steegers, E A P, Verhulst, F C, Mackenbach, J P, Raat, H (2009). Explaining educational inequalities in preterm birth: the generation r study. Arch. Dis. Child. Fetal Neonatal Ed. 94: F28-F34 [Abstract] [Full Text]  
• Lang, I. A., Llewellyn, D. J., Langa, K. M., Wallace, R. B., Melzer, D. (2008). Neighbourhood deprivation and incident mobility disability in older adults. Age Ageing 37: 403-410 [Abstract] [Full Text]  

eLetters:

Read all eLetters

This may be due to testosterone levels...

James M. Howard

Fetal Neonatal Ed. Online, 3 Jan 2007 [Full text]