Abstract
BackgroundSocial factors affect the risk of very preterm birth and may affect subsequent outcomes in those born preterm. We assessed the influence of neighbourhood socio-economic characteristics on the risk and outcomes of singleton very preterm birth (<32 weeks of gestation) in two European regions with different health systems.MethodsLive births (n=1118) from a population-based cohort of very preterm infants in 2003 in Trent (UK) and Ile-de-France (France) regions were geocoded to their neighbourhood census tracts. Odds ratios for very preterm singleton birth by neighbourhood characteristics (unemployment rate, proportion manual workers, proportion with high school education only, non home ownership) were computed using infants enumerated in the census as a control population. The impact of neighbourhood variables was further assessed by pregnancy and delivery characteristics and short term infant outcomes.ResultsRisk of very preterm singleton birth was higher in more deprived neighbourhoods in both regions (OR between 2.5 and 1.5 in the most versus least deprived quartiles). No consistent associations were found between neighbourhood deprivation and maternal characteristics or health outcomes for very preterm births, although infants in more deprived neighbourhoods were less likely to be breastfed at discharge.ConclusionsNeighbourhood deprivation had a strong consistent impact on the risk of singleton very preterm birth in two European regions, but did not appear to be associated with maternal characteristics or infant outcomes. Differences in breastfeeding at discharge suggest that socio-economic factors may affect long term outcomes.
Highlights
Social factors affect the risk of very preterm birth and may affect subsequent outcomes in those born preterm
Very preterm infants Data were available for very preterm infants born between 22+0 to 31+6 weeks from the former Trent health region (UK) and Ile-de-France (France), two regions participating in the population-based MOSAIC study [28]
The distribution of pregnancy complications and very preterm infant outcomes differed between regions, except for hypertension during pregnancy, caesarean section before labour and in-hospital mortality
Summary
Social factors affect the risk of very preterm birth and may affect subsequent outcomes in those born preterm. Preterm birth is related to individual social factors, including maternal education, occupation and ethnicity [1,2], as well as neighbourhood social characteristics [1,3] The influence of these factors seems to be greater for very preterm births (
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