Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Int J Gynaecol Obstet. 2018 Jan;140(1):87-92. doi: 10.1002/ijgo.12347. Epub 2017 Nov 6.
To investigate associations between economic inequality in preterm delivery.
The present secondary analysis included cross-sectional data collected in interviews with patients following delivery at 103 hospitals in Tehran, Iran, between July 6 and 21, 2015. Principal component analysis was used to measure the socioeconomic status of participants and the concentration index was used to measure inequalities in preterm delivery among patients of different socioeconomic status.
Data were included from 5170 patients. The concentration index for preterm delivery was 0.087 (95% confidence interval 0.036-0.134), indicating that preterm deliveries were concentrated among patients with higher socioeconomic status. Higher socioeconomic status (94%), younger maternal age (29%), younger paternal age (21%), and being a homemaker (17%) had the highest positive contributions to the measured inequalities in preterm deliveries; vaginal delivery (-58%) had the highest negative contribution.
Preterm deliveries were distributed unequally among the study patients in Iran, and were concentrated among patients of higher socioeconomic status. Alongside future etiological studies, reproductive programs in Iran should focus on this population to redress the observed inequality.
探讨早产与经济不平等之间的关联。
本二次分析纳入了 2015 年 7 月 6 日至 21 日在伊朗德黑兰的 103 家医院进行的产后患者访谈收集的横断面数据。主成分分析用于衡量参与者的社会经济地位,集中指数用于衡量不同社会经济地位患者的早产不平等情况。
共纳入 5170 名患者。早产的集中指数为 0.087(95%置信区间 0.036-0.134),表明早产集中在社会经济地位较高的患者中。较高的社会经济地位(94%)、较年轻的母亲年龄(29%)、较年轻的父亲年龄(21%)和家庭主妇(17%)对早产不平等的衡量有最高的正贡献;阴道分娩(-58%)有最高的负贡献。
伊朗的研究患者中早产分布不均,集中在社会经济地位较高的患者中。除了未来的病因学研究外,伊朗的生殖计划还应关注这一人群,以纠正观察到的不平等现象。