早产与社会经济发展的关联：全国数据分析。

Association between preterm births and socioeconomic development: analysis of national data.

机构信息

Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brasil.

Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, Brasil.

出版信息

BMC Public Health. 2022 Nov 3;22(1):2014. doi: 10.1186/s12889-022-14376-2.

DOI:10.1186/s12889-022-14376-2

PMID:36329411

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9632029/

Abstract

BACKGROUND

The increasing prevalence of preterm birth, which is a global phenomenon, is attributable to the increased medical indications, artificial gestations, and some socioeconomic factors. This study was conducted to identify whether development and equality indices are associated with the incidence of preterm birth, specifically, spontaneous and elective preterm births.

METHODS

This retrospective observational study comprised an analysis of data on live births from 2019 in Brazil and on socioeconomic indices that were derived from census information in 2017. Data were summarised using absolute and relative frequencies. Spearman's correlation was used to determine the correlation between socioeconomic factors and the preterm birth rate. Multiple beta regression analysis was performed to determine the best model of socioeconomic covariates and preterm birth rate. The significance level was set at 5%.

RESULTS

In 2019 in Brazil, the preterm birth rate was 11.03%, of which 58% and 42% were spontaneous and elective deliveries, respectively. For all preterm births, Spearman's correlation varied from ρ = 0.4 for the Gini Index and ρ = - 0.24 for illiteracy. The best fit modelled the spontaneous preterm birth fraction as a negative function of the Human Development Index (HDI). The best-fit model considered the expected elective preterm birth fraction as a positive function of the HDI and as a negative function of the Gini Index, which was used as a precision parameter.

CONCLUSIONS

We observed a reduction in the fraction of spontaneous preterm births; however, the distribution was not uniform in the territory: higher rates of spontaneous preterm birth were noticed in the north, northeast, and mid-west regions. Thus, areas with lower education levels and inequal income distribution have a higher proportion of spontaneous preterm birth. The fraction of elective preterm birth was positively associated with more advantaged indices of socioeconomic status.

摘要

背景

早产的发生率不断上升，这是一个全球性现象，其原因可归咎于医疗指征的增加、人工妊娠和一些社会经济因素。本研究旨在确定发展和公平指数是否与早产的发生率有关，特别是自发性早产和选择性早产。

方法

本回顾性观察性研究分析了 2019 年巴西的活产数据和 2017 年人口普查信息得出的社会经济指数。数据采用绝对和相对频率进行总结。采用 Spearman 相关分析来确定社会经济因素与早产发生率之间的相关性。采用多元β回归分析来确定社会经济协变量和早产发生率的最佳模型。显著性水平设定为 5%。

结果

2019 年，巴西的早产率为 11.03%，其中 58%和 42%分别为自发性早产和选择性早产。对于所有的早产，Spearman 相关系数的范围从基尼指数的 ρ=0.4 到文盲率的 ρ=-0.24。最佳拟合模型将自发性早产率作为人类发展指数（HDI）的负函数进行建模。最佳拟合模型将预期选择性早产率视为 HDI 的正函数，同时视为基尼指数的负函数，基尼指数被用作精度参数。