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Cross-Country individual participant analysis of 4.1 million singleton births in 5 countries with very high human development index confirms known associations but provides no biologic explanation for 2/3 of all preterm births
- Source :
- Ferrero, D M, Larson, J, Jacobsson, B, Di Renzo, G C, Norman, J E, Martin, J N, D’alton, M, Castelazo, E, Howson, C P, Sengpiel, V, Bottai, M, Mayo, J A, Shaw, G M, Verdenik, I, Tul, N, Velebil, P, Cairns-smith, S, Rushwan, H, Arulkumaran, S, Howse, J L, Simpson, J L & Luo, Z (ed.) 2016, ' Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births ', PLoS ONE, vol. 11, no. 9, pp. e0162506 . https://doi.org/10.1371/journal.pone.0162506, PLoS ONE, PLoS ONE, Vol 11, Iss 9, p e0162506 (2016)
- Publication Year :
- 2016
-
Abstract
- Background Preterm birth is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. Understanding of risk factors remains poor, and preventive interventions have only limited benefit. Large differences exist in preterm birth rates across high income countries. We hypothesized that understanding the basis for these wide variations could lead to interventions that reduce preterm birth incidence in countries with high rates. We thus sought to assess the contributions of known risk factors for both spontaneous and provider-initiated preterm birth in selected high income countries, estimating also the potential impact of successful interventions due to advances in research, policy and public health, or clinical practice. Methods We analyzed individual patient-level data on 4.1 million singleton pregnancies from four countries with very high human development index (Czech Republic, New Zealand, Slovenia, Sweden) and one comparator U.S. state (California) to determine the specific contribution (adjusting for confounding effects) of 21 factors. Both individual and population-attributable preterm birth risks were determined, as were contributors to cross-country differences. We also assessed the ability to predict preterm birth given various sets of known risk factors. Findings Previous preterm birth and preeclampsia were the strongest individual risk factors of preterm birth in all datasets, with odds ratios of 4.6–6.0 and 2.8–5.7, respectively, for individual women having those characteristics. In contrast, on a population basis, nulliparity and male sex were the two risk factors with the highest impact on preterm birth rates, accounting for 25–50% and 11–16% of excess population attributable risk, respectively (p
- Subjects :
- Male
Pediatrics
Databases, Factual
Maternal Health
Slovenia
Psychological intervention
lcsh:Medicine
California
Geographical Locations
0302 clinical medicine
Pregnancy
Risk Factors
Medicine and Health Sciences
Public and Occupational Health
030212 general & internal medicine
lcsh:Science
Czech Republic
education.field_of_study
030219 obstetrics & reproductive medicine
Multidisciplinary
Obstetrics and Gynecology
Europe
Premature Birth
Regression Analysis
Female
Developed country
Research Article
medicine.medical_specialty
Population
Oceania
Preterm Birth
Birth rate
03 medical and health sciences
Population Metrics
medicine
Humans
education
Demography
Sweden
Health Care Policy
Population Biology
business.industry
Developed Countries
lcsh:R
Infant, Newborn
Biology and Life Sciences
Health Risk Analysis
Odds ratio
Birth Rates
medicine.disease
Infant mortality
United States
Pregnancy Complications
Health Care
Attributable risk
Multivariate Analysis
People and Places
North America
Birth
Women's Health
lcsh:Q
business
New Zealand
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- Ferrero, D M, Larson, J, Jacobsson, B, Di Renzo, G C, Norman, J E, Martin, J N, D’alton, M, Castelazo, E, Howson, C P, Sengpiel, V, Bottai, M, Mayo, J A, Shaw, G M, Verdenik, I, Tul, N, Velebil, P, Cairns-smith, S, Rushwan, H, Arulkumaran, S, Howse, J L, Simpson, J L & Luo, Z (ed.) 2016, ' Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index Confirms Known Associations but Provides No Biologic Explanation for 2/3 of All Preterm Births ', PLoS ONE, vol. 11, no. 9, pp. e0162506 . https://doi.org/10.1371/journal.pone.0162506, PLoS ONE, PLoS ONE, Vol 11, Iss 9, p e0162506 (2016)
- Accession number :
- edsair.doi.dedup.....c1f23b95fd99ef3f013361798fc7f424