Geographical differences in preterm delivery rates in Sweden: A population-based cohort study

Area of Science:

• Reproductive Health
• Public Health
• Environmental Epidemiology

Background:

• Preterm delivery is a significant global public health concern.
• Understanding geographical variations in preterm birth rates is crucial, especially in highly developed countries.
• Socioeconomic and environmental factors may contribute to disparities in preterm delivery.

Purpose of the Study:

• To investigate preterm delivery rate variations within a highly developed country (Sweden).
• To explore the influence of rural versus urban environmental and socioeconomic factors on preterm delivery.
• To identify potential drivers of geographical disparities in preterm birth.

Main Methods:

• A population-based study utilizing Swedish Medical Birth Register data (1998-2013).
• Multiple linear regression models adjusted for known risk factors (smoking, ethnicity, education, age, etc.).
• Analysis of municipality-level effects and the impact of rural/urban factors on gestational age.

Main Results:

• The overall preterm delivery rate was 4.12%, with significant municipal variations (1.73% to 6.31%).
• Municipality-level factors explained approximately 20% of the variance in gestational age.
• Longer gestational ages were observed in areas with higher urban land use.

Conclusions:

• Significant geographical disparities in preterm delivery rates persist after adjusting for individual risk factors.
• Urban environmental factors may play a role in influencing gestational age and preterm birth rates.
• Further research into the 'urbanity effect' is warranted to explain preterm delivery variations in high-income nations.