Oftedal Anne-Marie, Busterud Kari, Irgens Lorentz M, Haug Kjell, Rasmussen Svein
Department of Global Public Health and Primary Care, University of Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Norway The Medical Birth Registry of Norway, Norwegian Institute of Public Health, Norway.
Scand J Public Health. 2016 Aug;44(6):587-92. doi: 10.1177/1403494816653288. Epub 2016 Jun 15.
Preterm birth is a major cause of perinatal mortality and morbidity and is strongly associated with socio-economic factors. The objective of this study was to examine the associations of maternal education, marital status and ethnicity with preterm birth and to determine the extent to which such associations can be explained by the established risk factors of maternal age, parity and smoking.
This was a register-based cohort study with data from the Medical Birth Registry of Norway 1999-2009 and Statistics Norway. The sample included all singleton spontaneous births in Norway from 1999 to 2009 (n=494,073). The main outcome measure was preterm birth (gestational age <37 weeks).
Low maternal education and single motherhood were associated with preterm birth. After adjustment for the established risk factors, the excess risks were reduced, but remained statistically significant. The relative risk for low education was reduced from 1.50 to 1.36 and for single motherhood from 1.50 to 1.28. Women from Asia had a higher risk of preterm birth than Norwegian-born women (relative risk 1.29) with minor effects of adjustment. CONCLUSIONS SEVERAL SOCIO-ECONOMIC RISK FACTORS ARE ASSOCIATED WITH PRETERM BIRTH IN NORWAY IN ADDITION TO THE ESTABLISHED RISK FACTORS, PRENATAL HEALTH CARE SHOULD FOCUS ON HIGH-RISK GROUPS DEFINED BY MATERNAL EDUCATION, MARITAL STATUS AND ETHNICITY.
早产是围产期死亡和发病的主要原因，且与社会经济因素密切相关。本研究的目的是探讨母亲教育程度、婚姻状况和种族与早产之间的关联，并确定这些关联在多大程度上可以由母亲年龄、产次和吸烟等既定风险因素来解释。
这是一项基于登记的队列研究，数据来自挪威1999 - 2009年医疗出生登记处和挪威统计局。样本包括1999年至2009年挪威所有单胎自然分娩（n = 494,073）。主要结局指标是早产（孕周<37周）。
母亲教育程度低和单身母亲身份与早产有关。在对既定风险因素进行调整后，额外风险有所降低，但仍具有统计学意义。低教育程度的相对风险从1.50降至1.36，单身母亲身份的相对风险从1.50降至1.28。亚洲女性早产风险高于挪威出生的女性（相对风险1.29），调整后的影响较小。结论：除既定风险因素外，挪威还有几个社会经济风险因素与早产有关，产前保健应关注由母亲教育程度、婚姻状况和种族定义的高危人群。
