Thompson John M D, Irgens Lorentz M, Rasmussen Svein, Daltveit Anne Kjersti
The Medical Birth Registry of Norway, Locus of Registry Based Epidemiology, University of Bergen, Bergen, Norway.
Paediatr Perinat Epidemiol. 2006 May;20(3):182-7. doi: 10.1111/j.1365-3016.2006.00711.x.
The rate of preterm birth in the developed world has been shown to be increasing, in part attributable to obstetric intervention. It has been suggested that this may be a differential increase between socio-economic groups. We aimed to assess whether the preterm rate in Norway is different in socio-economic groups defined by maternal education, and to determine the extent to which a difference is attributable to a socio-economic differential in obstetrical intervention, in terms of caesarean section or induction of labour. We used data from the Medical Birth Registry of Norway from 1980 to 1998 with preterm rate as the outcome and maternal educational level, marital status and obstetric intervention as exposure variables. In multivariable analyses, adjustment was made for maternal age, year of birth and birth order, and secular trends were assessed according to year of birth. The preterm birth rate was highest in the lowest socio-economic group. An increase of 25.2% in the preterm rate was seen over the observation period. No apparent differential was seen in the increase of the crude preterm rates between socio-economic groups, although in multivariable analyses there was a significant interaction between socio-economic group and time, implying a stronger effect of low education towards the end of the observation period attributable to demographic change. In conclusion, the preterm birth rate increased over time, but was mainly due to an increase in obstetric interventions. No closing of the gap between socio-economic groups was observed.
发达国家的早产率呈上升趋势，部分原因是产科干预。有人认为，不同社会经济群体之间的早产率可能存在差异。我们旨在评估挪威不同社会经济群体（以母亲教育程度划分）的早产率是否存在差异，并确定这种差异在多大程度上归因于剖宫产或引产等产科干预措施方面的社会经济差异。我们使用了挪威医疗出生登记处1980年至1998年的数据，将早产率作为结果变量，母亲教育水平、婚姻状况和产科干预作为暴露变量。在多变量分析中，对母亲年龄、出生年份和产次进行了调整，并根据出生年份评估了长期趋势。社会经济地位最低的群体早产率最高。在观察期内，早产率上升了25.2%。不同社会经济群体之间的粗早产率上升没有明显差异，尽管在多变量分析中，社会经济群体与时间之间存在显著交互作用，这意味着由于人口结构变化，在观察期结束时低教育程度的影响更大。总之，表示早产率随时间上升，但主要是由于产科干预的增加。不同社会经济群体之间的差距没有缩小。
