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Published on: January 12, 2018
Social, economic, and health indexes affecting epidemiology of preterm birth: A cross-sectional study
Shayan Mostafaei1, Alireza A Shamshirsaz2, Amir H Norooznezhad3
1Department of Medical Epidemiology and Biostatistics Karolinska Institute Stockholm Sweden.
Insights
Economic, developmental, and health factors significantly influence preterm birth (PTB) rates globally. Understanding these factors, like prenatal care access, is crucial for accurate PTB epidemiology studies.
Area of Science:
- Global Health
- Epidemiology
- Public Health Policy
Background:
- Preterm birth (PTB) is a major cause of newborn morbidity and mortality worldwide.
- Socioeconomic, developmental, and health factors are hypothesized to influence PTB prevalence.
- Accurate PTB epidemiology requires understanding these potential confounding factors.
Purpose of the Study:
- To investigate the influence of economic, human developmental, and health indexes on PTB prevalence.
- To identify key factors associated with high and low PTB rates across countries.
Main Methods:
- Extracted data for top 10 highest and lowest PTB prevalence countries from the Global Burden of Disease report.
- Collected economic (income, GDP per capita), health (maternal mortality, prenatal care), and developmental (HDI) indexes from World Bank and UN.
- Analyzed data using truncated Bayesian linear regression, decision trees, and k-means clustering.
Main Results:
- Pregnancy Prenatal Care Rate significantly impacts PTB rates in high-prevalence countries.
- Maternal mortality rate, human developmental index rank, and prenatal care rate affect PTB in low-prevalence countries.
- Clustering based on socioeconomic, developmental, and health indexes closely mirrored PTB rate-based clustering (Rand index = 0.823).
Conclusions:
- Epidemiological studies of PTB must account for socioeconomic, developmental, and health confounders.
- These factors are critical for accurate global and nation-based PTB prevalence assessments.
- Identifying these influences can inform targeted public health interventions.
Background And Aim:
Preterm birth (PTB) accompanies with morbidities and mortality among newborns. This study aimed to show that different factors such as economic (adjusted net national income and gross domestic product [GDP] per capita), human developmental (human developmental index), and health (overall health performance, pregnancy prenatal care rate, and modeled estimated maternal mortality rate) indexes might influence the prevalence of PTB.
Methods:
To this, the top 10 countries with the highest and lowest prevalence of PTB were extracted from the Global Burden of Disease report for PTB. Then, we have gathered some common indexes for economic (adjusted net national income and GDP per capita), health-related (overall health performance, pregnancy prenatal care rate, and modeled estimated maternal mortality rate), and combined developmental (human developmental index) factors from different resources including World Bank and United Nations for those countries. The truncated Bayesian linear regression model, decision tree, and k-means clustering algorithms were used for data analysis.
Results:
The results showed Pregnancy Prenatal Care Rate index has a significant effect on the PTB rate in the top 10 countries with the highest prevalence of PTB. Also, for the top 10 less prevalent countries for PTB, it was shown that modeled estimated maternal mortality rate, human developmental index rank, and pregnancy prenatal care rate have significant effects on PTB rate. In addition, the clustering based on the similarities in socioeconomic, human developmental, and health indexes were approximately like with the clustering of the countries based on the PTB rates (Rand index = 0.823).
Conclusion:
The results showed studies on the epidemiology of PTB (either worldwide or nation-based) should consider these confounder factors to obtain accurate results.
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