Secular trends and age-period-cohort effect on adverse perinatal outcomes in Hubei, China (2011-2019)

Area of Science:

• Perinatal Health
• Public Health
• Epidemiology

Background:

• Adverse perinatal outcomes pose a global public health challenge, with increasing incidence noted in China.
• The underlying causes for these trends remain incompletely understood.
• This study investigates trends and contributing factors in Hubei, China.

Purpose of the Study:

• To determine secular trends in adverse perinatal outcomes in Hubei, China, from 2011 to 2019.
• To analyze the age-period-cohort effects on these outcomes.
• To identify specific risk factors associated with adverse perinatal events.

Main Methods:

• Retrospective study conducted in a tertiary hospital in Hubei, China, from 2011 to 2019.
• Analysis of age-standardized incidence rates for various adverse perinatal outcomes.
• Age-period-cohort modeling to assess temporal trends and risk associations.

Main Results:

• Significant decreases observed in preterm births (22%), low birth weight (LBW) (28.5%), and fetal distress (64.2%) from 2011-2019.
• Extremes of maternal age (18-20 and 42-44 years) were linked to higher risks of preterm birth, perinatal mortality, LBW, low ponderal index (LPI), low Apgar score, and congenital defects.
• Specific periods (2017-2019) and cohorts (young and old) showed elevated risks for perinatal mortality, intrauterine growth restriction (IUGR), fetal distress, preterm birth, and LBW.

Conclusions:

• While some adverse perinatal outcomes have declined in Hubei over the past nine years, significant risks persist.
• Extremes in maternal age are associated with increased adverse perinatal outcomes.
• Young and old birth cohorts also present higher risks for critical adverse perinatal outcomes, highlighting the need for targeted interventions.