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Published on: January 12, 2018
Spatial-temporal distribution of preterm birth in China, 1990-2020: A systematic review and modelling analysis
Wei-Hua Hu1,2,3,4, Xin-Yuan Gao1, Xiu-Xiu Li5
1Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Background:
Little is known about the long-term trends of preterm birth rates in China and their geographic variation by province.
Objectives:
To estimate the annual spatial-temporal distribution of preterm birth rates in China by province from 1990 to 2020.
Data Sources:
We searched PubMed, EMBASE, Web of Science, CNKI, WANFANG and VIP from January 1990 to September 2023.
Study Selection And Data Extraction:
Studies that provided data on preterm births in China after 1990 were included. Data were extracted following the Guidelines for Accurate and Transparent Health Estimates Reporting.
Synthesis:
We assessed the quality of each survey using a 9-point checklist. We estimated the annual preterm birth risk by province using Bayesian multilevel logistic regression models considering potential socioeconomic, environmental, and sanitary predictors.
Results:
Based on 634 survey data from 343 included studies, we found a gradual increase in the preterm birth risk in most provinces in China since 1990, with an average annual increase of 0.7% nationally. However, the preterm birth rates in Inner Mongolia, Hubei, and Fujian Province showed a decline, while those in Sichuan were quite stable since 1990. In 2020, the estimates of preterm birth rates ranged from 2.9% (95% Bayesian credible interval [BCI] 2.1, 3.8) in Inner Mongolia to 8.5% (95% BCI 6.6, 10.9) in Jiangxi, with the national estimate of 5.9% (95% BCI 4.3, 8.1). Specifically, some provinces were identified as high-risk provinces for either consistently high preterm birth rates (e.g. Jiangxi) or relatively large increases (e.g. Shanxi) since 1990.
Conclusions:
This study provides annual information on the preterm birth risk in China since 1990 and identifies high-risk provinces to assist in targeted control and intervention for this health issue.
