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Exploring Educational Disparities in Risk of Preterm Delivery: A Comparative Study of 12 E uropean Birth Cohorts
Author(s) -
Poulsen Gry,
StrandbergLarsen Katrine,
Mortensen Laust,
Barros Henrique,
Cordier Sylvaine,
Correia Sofia,
Danileviciute Asta,
Eijsden Ma,
FernándezSomoano Ana,
Gehring Ulrike,
Grazuleviciene Regina,
Hafkampde Groen Esther,
Henriksen Tine Brink,
Jensen Morten Søndergaard,
Larrañaga Isabel,
Magnus Per,
Pickett Kate,
Raat Hein,
Richiardi Lorenzo,
Rouget Florence,
Rusconi Franca,
Stoltenberg Camilla,
Uphoff Eleonora P.,
Vrijkotte Tanja G. M.,
Wijga Alet H.,
Vrijheid Martine,
Osler Merete,
Andersen AnneMarie Nybo
Publication year - 2015
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12185
Subject(s) - medicine , demography , singleton , confidence interval , cohort , cohort study , preterm delivery , premature birth , obstetrics , disadvantaged , pregnancy , gestation , pediatrics , genetics , sociology , political science , law , biology
Background An association between education and preterm delivery has been observed in populations across E urope, but differences in methodology limit comparability. We performed a direct cross‐cohort comparison of educational disparities in preterm delivery based on individual‐level birth cohort data. Methods The study included data from 12 E uropean cohorts from D enmark, E ngland, F rance, L ithuania, the N etherlands, N orway, I taly, P ortugal, and S pain. The cohorts included between 2434 and 99 655 pregnancies. The association between maternal education and preterm delivery (22–36 completed weeks of gestation) was reported as risk ratios, risk differences, and slope indexes of inequality with 95% confidence intervals ( CI s).Results Singleton preterm live delivery proportion varied between 3.7% and 7.5%. There were large variations between the cohorts in the distribution of education and maternal characteristics. Nevertheless, there were similar educational differences in risk of preterm delivery in 8 of the 12 cohorts with slope index of inequality varying between 2.2 [95% CI 1.1, 3.3] and 4.0 [95% CI 1.4, 6.6] excess preterm deliveries per 100 singleton deliveries among the educationally most disadvantaged, and risk ratio between the lowest and highest education category varying from 1.4 [95% CI 1.1, 1.8] to 1.9 [95% CI 1.2, 3.1]. No associations were found in the last four cohorts. Conclusions Educational disparities in preterm delivery were found all over E urope. Despite differences in the distributions of education and preterm delivery, the results were remarkably similar across the cohorts. For those few cohorts that did not follow the pattern, study and country characteristics did not explain the differences.