Stefan Johansson
23rd December 2006, 22:49
Leading article - January 2007
This Leading article is about socioeconomic inequalities and in the incidence of very preterm birth. It is published in collaboration with the journal Archives of disease in childhood (ADC).
The article, published in the January issue of the ADC Fetal & Neonatal edition, is written by a research group based at University of Leicester, Leicester, UK.
The abstract is published below. The article could be read and downloaded at at ADC web site (http://fn.bmj.com/cgi/content/full/92/1/F11).
Permission to publish the abstract and link to the article has been given by the Editorial Board of ADC.
Please note that the free full text access to all contents at the ADC web site is offered till the 31st of January. Visit this link! (http://adc.bmj.com/freetrial/)
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Socioeconomic inequalities in very preterm birth rates
L K Smith, E S Draper, B N Manktelow, J S Dorling and D J Field
Department of Health Sciences, University of Leicester, Leicester, UK
Department of Health Sciences, University of Leicester, Neonatal Unit, Leicester Royal Infirmary, Leicester, UK
Aims
To investigate the extent of socioeconomic inequalities in the incidence of very preterm birth over the past decade.
Methods
Ecological study of all 549 618 births in the former Trent health region, UK, from 1 January 1994 to 31 December 2003. All singleton births of 22+0 to 32+6 weeks gestation (7 185 births) were identified from population surveys of neonatal services and stillbirths. Poisson regression was used to calculate incidence of very preterm birth (22–32 weeks) and extremely preterm birth (22–28 weeks) by year of birth and decile of deprivation (child poverty section of the Index of Multiple Deprivation).
Results
Incidence of very preterm singleton birth rose from 11.9 per 1000 births in 1994 to 13.7 per 1000 births in 2003. Those from the most deprived decile were at nearly twice the risk of very preterm birth compared with those from the least deprived decile, with 16.4 per 1000 births in the most deprived decile compared with 8.5 per 1000 births in the least deprived decile (incidence rate ratio 1.94; 95% CI (1.73 to 2.17)). This deprivation gap remained unchanged throughout the 10-year period. The magnitude of socio-economic inequalities was the same for extremely preterm births (22–28 weeks incidence rate ratio 1.94; 95% CI (1.62 to 2.32)).
Conclusions
This large, unique dataset of very preterm births shows wide socio-economic inequalities that persist over time. These findings are likely to have consequences on the burden of long-term morbidity. Our research can assist future healthcare planning, the monitoring of socio-economic inequalities and the targeting of interventions in order to reduce this persistent deprivation gap.
* * * * * * * * * * * * * * * * * * *
You may comment the article directly below or discuss Socioeconomic aspects of neonatal care in the forum Education, Organisation and Evaluation.
This Leading article is about socioeconomic inequalities and in the incidence of very preterm birth. It is published in collaboration with the journal Archives of disease in childhood (ADC).
The article, published in the January issue of the ADC Fetal & Neonatal edition, is written by a research group based at University of Leicester, Leicester, UK.
The abstract is published below. The article could be read and downloaded at at ADC web site (http://fn.bmj.com/cgi/content/full/92/1/F11).
Permission to publish the abstract and link to the article has been given by the Editorial Board of ADC.
Please note that the free full text access to all contents at the ADC web site is offered till the 31st of January. Visit this link! (http://adc.bmj.com/freetrial/)
* * * * * * * * * * * * * * * * * * *
Socioeconomic inequalities in very preterm birth rates
L K Smith, E S Draper, B N Manktelow, J S Dorling and D J Field
Department of Health Sciences, University of Leicester, Leicester, UK
Department of Health Sciences, University of Leicester, Neonatal Unit, Leicester Royal Infirmary, Leicester, UK
Aims
To investigate the extent of socioeconomic inequalities in the incidence of very preterm birth over the past decade.
Methods
Ecological study of all 549 618 births in the former Trent health region, UK, from 1 January 1994 to 31 December 2003. All singleton births of 22+0 to 32+6 weeks gestation (7 185 births) were identified from population surveys of neonatal services and stillbirths. Poisson regression was used to calculate incidence of very preterm birth (22–32 weeks) and extremely preterm birth (22–28 weeks) by year of birth and decile of deprivation (child poverty section of the Index of Multiple Deprivation).
Results
Incidence of very preterm singleton birth rose from 11.9 per 1000 births in 1994 to 13.7 per 1000 births in 2003. Those from the most deprived decile were at nearly twice the risk of very preterm birth compared with those from the least deprived decile, with 16.4 per 1000 births in the most deprived decile compared with 8.5 per 1000 births in the least deprived decile (incidence rate ratio 1.94; 95% CI (1.73 to 2.17)). This deprivation gap remained unchanged throughout the 10-year period. The magnitude of socio-economic inequalities was the same for extremely preterm births (22–28 weeks incidence rate ratio 1.94; 95% CI (1.62 to 2.32)).
Conclusions
This large, unique dataset of very preterm births shows wide socio-economic inequalities that persist over time. These findings are likely to have consequences on the burden of long-term morbidity. Our research can assist future healthcare planning, the monitoring of socio-economic inequalities and the targeting of interventions in order to reduce this persistent deprivation gap.
* * * * * * * * * * * * * * * * * * *
You may comment the article directly below or discuss Socioeconomic aspects of neonatal care in the forum Education, Organisation and Evaluation.