Association of socioeconomic status and clinical and demographic conditions with the prevalence of preterm birth

Abstract

Objective: To examine the effects of socioeconomic and demographic conditions on the prevalence of preterm birth in a local community.Methods: Pregnant women (aged ≥16 years) willing to provide informed consent in one of the two languages of the community were recruited in South Africa between August 2007 and January 2015. Specifically designed case report forms collected information and measurements prospectively.Results: After reviewing the medical records of 5806 women, it was possible to identify those who had spontaneous preterm birth (SPTB), induced preterm birth (IPTB), or spontaneous term birth (STB). Women with IPTB (vs SPTB) were more obese and had higher education levels and household incomes; more had telephones and running water at home. They enrolled earlier and more developed hypertension and pre-eclampsia.Women with SPTB (vs STB) were less obese, shorter, had smaller arm circumferences and higher gravidities and Edinburgh Depression Scores, lower education, fewer telephones, and less running water at home. More women with SPTB used methamphetamine, cigarettes, and were heavier smokers.Conclusion: SPTB and IPTB should not be conflated. Programs to reduce the high prevalence of SPTB should include improving education, lifestyle, and socioeconomic conditions. Addressing hypertension should help reduce preterm inductions. K E Y W O R D SInduced preterm birth; Pregnancy; Small for gestational age infants; Socioeconomic status; Spontaneous preterm birth; Spontaneous term birth

The Intricate Interactions between Maternal Smoking and Drinking During Pregnancy and Birthweight Z-Scores of Preterm Births

“…In our study, mid-upper arm circumference was significantly smaller in the spontaneous preterm birth group. In a previous study, we found that a small mid-upper arm circumference was strongly associated with a higher risk of spontaneous preterm birth [41]. In addition, many other studies confirm that women who were underweight during pregnancy or had a small mid-upper arm circumference, had an increased risk of preterm birth [15,18,42, and 43], suggesting that maternal under nutrition contributes to preterm birth.…”

The tragedy of smoking, alcohol, and multiple substance use during pregnancy

“…Since we, and others, have shown that MUAC, maternal education and household income play important roles in newborn and 1-year outcomes, these were used as confounders. [35,36] Statistical analyses were performed using the Statistica data analysis software system, version 13 (TIBCO Software Inc., USA). Descriptive statistics were used to describe continuous variables, which were compared between groups with analysis of variance (ANOVA).…”

“…Since we, and others, have shown that MUAC, maternal education and household income play important roles in newborn and 1-year outcomes, these were used as confounders. [ 35 , 36 ]…”

“…Our finding that women who smoked, whether combined with drugs and/or alcohol or not, had significantly smaller MUACs, has been confirmed by two previous studies. [26,35] The reduced MUAC, associated with cigarette smoking and indicating poorer nutritional status, was associated with an increased risk of spontaneous preterm birth as well as a lower infant BWZ. [26,35] The trend in education (Fig.…”

“…[26,35] The reduced MUAC, associated with cigarette smoking and indicating poorer nutritional status, was associated with an increased risk of spontaneous preterm birth as well as a lower infant BWZ. [26,35] The trend in education (Fig. 4) and income (Table 2) from Control to All was lower education and lower income with more substances used.…”