Institut national de santé publique du Québec, 190, boulevard Crémazie Est, Montréal, Québec H2P 1E2, Canada.
Soc Sci Med. 2012 Sep;75(6):1032-7. doi: 10.1016/j.socscimed.2012.04.033. Epub 2012 May 24.
Evidence suggests that individual socioeconomic status is a better predictor of preterm birth (PTB) than other individual social characteristics, but it is not clear if socioeconomic (material) area context is likewise more strongly related to PTB than social area characteristics. We compared material and social area deprivation to determine which was more strongly associated with PTB. Live singleton births from Québec, Canada were obtained for 1999-2006 (N = 581,898). PTB was defined as <37 completed gestational weeks. Two composite indices representing area-level material and social deprivation were used in Cox proportional hazards regression models to compute hazard ratios (HR) and 95% confidence intervals (CI) for PTB, accounting for individual-level characteristics including maternal education. Results indicated that PTB rates were higher for areas with high material (7.1%) and social (6.8%) deprivation than those with low material (5.5%) and social (5.9%) deprivation. Adjusted hazards of PTB were slightly greater for material deprivation than social deprivation. These findings indicate that material area deprivation is marginally more strongly associated with PTB than social deprivation, but it is not clear that interventions to prevent PTB should focus on material deprivation any more than on social area deprivation.
有证据表明，个体的社会经济地位是预测早产（PTB）的更好指标，优于其他个体社会特征，但尚不清楚社会经济（物质）区域背景与 PTB 的相关性是否同样强于社会区域特征。我们比较了物质和社会区域贫困程度，以确定哪个与 PTB 的相关性更强。1999-2006 年，我们从加拿大魁北克获取了活单胎分娩数据（N=581898）。PTB 的定义为<37 周完成的妊娠期。在 Cox 比例风险回归模型中使用了两个代表区域水平物质和社会剥夺的综合指数，以计算 PTB 的风险比（HR）和 95%置信区间（CI），同时考虑了包括母亲教育在内的个体水平特征。结果表明，物质剥夺程度高（7.1%）和社会剥夺程度高（6.8%）的区域的 PTB 发生率高于物质剥夺程度低（5.5%）和社会剥夺程度低（5.9%）的区域。调整后的 PTB 风险略高于物质剥夺，而低于社会剥夺。这些发现表明，物质区域剥夺与 PTB 的相关性略强于社会剥夺，但尚不清楚预防 PTB 的干预措施是否应更侧重于物质剥夺，而不是社会区域剥夺。
