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Maternal educational level and preterm birth: Exploring inequalities in a hospital-based cohort study
Laura Granés1, Isabel Torà-Rocamora1,2, Montse Palacio3
1Preventive Medicine and Epidemiology Department, Hospital Clínic de Barcelona, Barcelona, Spain.
Plos One
|April 5, 2023
Summary
Maternal education level significantly impacts preterm birth risk. Factors like maternal overweight, smoking, and infections mediate this association, highlighting the need for improved health literacy and prenatal care to reduce disparities.
Area of Science:
- Public Health
- Epidemiology
- Maternal Health
Background:
- Maternal educational level is linked to preterm birth, but causal pathways remain unclear.
- Chronic conditions, pregnancy complications, and health behaviors may mediate this relationship.
Purpose of the Study:
- To investigate the association between maternal educational level and preterm birth.
- To analyze the mediating roles of specific factors in this association.
Main Methods:
- Retrospective cohort study of 10,467 deliveries (2011-2017) at Hospital Clínic of Barcelona.
- Poisson regression used to calculate relative risks (RR) and mediation effects.
- Analysis included variables like body mass index, smoking, preeclampsia, and genitourinary infections.
Main Results:
- Lower maternal educational level was associated with a higher risk of preterm birth (RR 1.57, 95% CI 1.21, 2.03).
- Maternal overweight (indicated by body mass index) showed significant mediation.
- Smoking, drug use, preeclampsia, and genitourinary infections also contributed to the observed inequalities.
Conclusions:
- Maternal educational disparities contribute to preterm birth risk, mediated by factors including overweight and lifestyle choices.
- Interventions promoting health literacy and preventive care before and during pregnancy are crucial.
- Addressing these factors can help reduce preterm birth rates and associated perinatal health inequalities.
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