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Increasing educational inequality in preterm birth in Quebec, Canada, 1981-2006
Nathalie Auger1, Federico Roncarolo, Sam Harper
1Institut national de santé publique du Québec, 190 boulevard Crémazie Est, Montréal, Québec, Canada. nathalie.auger@inspq.qc.ca
Journal of Epidemiology and Community Health
|July 15, 2010
Summary
Educational inequalities in preterm birth (PTB) have widened in Québec. Both relative and absolute disparities in extreme and moderate PTB increased significantly between 1981 and 2006.
Area of Science:
- Public Health
- Epidemiology
- Sociomedical Sciences
Background:
- Limited research exists on the temporal relationship between maternal education and preterm birth (PTB).
- Investigating educational disparities in PTB is crucial for public health.
- This study addresses the gap by examining trends in PTB and maternal education in Québec.
Purpose of the Study:
- To determine if educational inequalities in PTB have increased over time in Québec, Canada.
- To analyze trends in extreme, very, and moderate PTB in relation to maternal education.
- To quantify changes in relative and absolute inequalities.
Main Methods:
- Analysis of 2,124,909 singleton live births in Québec from 1981 to 2006.
- Calculation of Relative Index of Inequality (RII) and Slope Index of Inequality (SII) to assess educational disparities.
- Adjustment for multiple confounding factors including maternal age, marital status, and parity.
Main Results:
- Rates of extreme and moderate PTB increased, while very PTB rates decreased.
- Statistically significant increases in RII observed for extreme and moderate PTB over the study period.
- Absolute differences in PTB proportions between least and most educated mothers widened for extreme and moderate PTB.
Conclusions:
- Both relative and absolute educational inequalities in extreme and moderate PTB have demonstrably increased in Québec.
- The largest relative increases in PTB inequality were associated with extreme PTB.
- Moderate PTB showed the largest absolute increases in educational inequality.
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