Secular trends and age-period-cohort effect on adverse perinatal outcomes in Hubei, China (2011–2019)

Abstract

The increasing trend in the incidence of adverse perinatal outcomes is a public health concern globally as well as in China. However, the causes of the increasing trend are not well understood. The present tertiary-hospital-based retrospective study (2011–2019) aims to determine the secular trends and age-period-cohort effect on adverse perinatal outcomes in Hubei, China. The age-standardized incidence rates of adverse perinatal outcomes significantly decreased such as preterm births by 22% [AAPC − 3.4% (95% CI − 7.8, − 1.2)], low birth weight (LBW) by 28.5% [AAPC − 4.7% (95% CI − 6.0, − 3.3)], and fetal distress by 64.2% [AAPC − 14.0% (95% CI − 17.8, − 10.0)] during 2011–2019. Both extremes of maternal age groups (18–20 years and 42–44 years) had a higher risk ratio for adverse perinatal outcomes including preterm birth, perinatal mortality, LBW, low ponderal index (LPI), low Apgar score, and congenital defect compared to the reference age group (30–32 years). A higher risk ratio for perinatal mortality, intrauterine growth restriction (IUGR), and fetal distress and a lower risk ratio for preterm births and LBW were observed in the period 2017–2019. Both the young cohort (1997–1999) and the old cohort (1976–1969) had a higher risk ratio for preterm birth, perinatal mortality, macrosomia, and congenital defect compared to the reference cohort (1982–1984). In conclusion, some of the adverse perinatal outcomes incidence significantly decreased in the last 9 years in Hubei. However, extremes of maternal age groups and both young and old cohorts were associated with a higher risk of preterm birth, perinatal mortality, and congenital defect.