Preterm Birth in the Context of Increasing Income Inequality.

Preterm Birth in the Context of Increasing Income Inequality. - 2016

CONCLUSIONS: The contextual effect of increasing income inequality on preterm birth risk merits further study. METHODS: We examined changes in inequality over time in relation to preterm birth among singleton deliveries from an electronic medical record-based cohort (n = 223,512) conducted in 11 U.S. states and the District of Columbia from 2002 to 2008. Increasing income inequality was defined as a positive change in state-level Gini coefficient from the year prior to birth. Multi-level models estimated the independent effect of increasing inequality on preterm birth (>22 and <37 weeks) controlling for maternal demographics, health behaviors, insurance status, chronic medical conditions, and state-level poverty and unemployment during the year of birth. OBJECTIVE: Preterm birth is a leading cause of infant morbidity and mortality. Little is known about the contextual effect of U.S. income inequality on preterm birth, an issue of increasing concern given that the current economic divide is the largest since 1928. RESULTS: The preterm birth rate was 12.3% where inequality increased and 10.9% where it did not. After adjustment, increasing inequality remained significantly associated with preterm birth (adjusted odds ratio 1.07, 95% confidence interval 1.04, 1.11). We observed no significant interaction by insurance status or race, suggesting that increasing inequality had a broad effect across the population.


English

1092-7875


*Poverty/sn [Statistics & Numerical Data]
*Premature Birth/et [Etiology]
Adolescent
Adult
Female
Humans
Infant
Infant Mortality/td [Trends]
Infant, Newborn
Pregnancy
Premature Birth/ep [Epidemiology]
Risk Factors
Socioeconomic Factors
United States/ep [Epidemiology]


MedStar Washington Hospital Center


Obstetrics and Gynecology/Maternal-Fetal Medicine


Journal Article
Research Support, N.I.H., Intramural

Powered by Koha