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Related Experiment Video

Updated: Jul 1, 2026

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
14:43

A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting

Published on: January 12, 2018

Area-level poverty and preterm birth risk: a population-based multilevel analysis.

Emily A DeFranco1, Min Lian, Louis A Muglia

  • 1Department of Obstetrics and Gynecology, Washington University School of Medicine, St, Louis, Missouri, USA. defranee@ucmail.uc.edu

BMC Public Health
|September 17, 2008
PubMed
Summary

Women in high-poverty counties face increased preterm birth risk. This study highlights socioeconomic deprivation as a significant factor influencing pregnancy outcomes, even with other risk factors present.

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Area of Science:

  • Public Health
  • Epidemiology
  • Sociomedical Sciences

Background:

  • Preterm birth (PTB) is a complex condition influenced by diverse factors including social, environmental, and genetic elements.
  • Socioeconomic status, particularly poverty, is a suspected contributor to PTB risk.
  • This study investigates the independent impact of county-level poverty on PTB risk using a large birth registry.

Purpose of the Study:

  • To estimate the independent effect of county-level poverty on the risk of preterm birth.
  • To utilize a population-based birth registry for robust statistical analysis.
  • To account for individual-level variables alongside area-level poverty rates.

Main Methods:

  • A population-based study using Missouri's birth certificate database (1989-1997).
  • Multilevel logistic regression analysis incorporating 634,994 births across 115 counties.
  • Individual factors (demographics, prenatal care, behavioral/medical risks) and county poverty rates (1990 US Census) were analyzed.

Main Results:

  • Preterm birth (< 35 weeks) occurred in 3.9% of pregnancies.
  • PTB rates increased with poverty quartiles, from 2.8% in the lowest to 4.9% in the highest.
  • Women in the highest poverty quartile had a significantly increased risk of PTB (adj OR 1.18), with similar effects for earlier gestational ages.

Conclusions:

  • Socioeconomic deprivation, indicated by high county-level poverty, is linked to increased preterm birth risk.
  • This association persists even after controlling for other individual-level risk factors.
  • The modest but significant increase in risk affects a substantial number of pregnancies in deprived areas.