Quantifying the Impact of Deprivation on Preterm Births A Retrospective Cohort Study 英文参考文献.docVIP

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Quantifying the Impact of Deprivation on Preterm Births A Retrospective Cohort Study 英文参考文献.doc

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Quantifying the Impact of Deprivation on Preterm Births A Retrospective Cohort Study 英文参考文献

QuantifyingtheImpactofDeprivationonPretermBirths: ARetrospectiveCohortStudy DavidTaylor-Robinson1*,UmberAgarwal2,PeterJ.Diggle3,MaryJanePlatt4,BillYoxall2 ,Zarko Alfirevic5 1DepartmentofPublicHealthandPolicy,UniversityofLiverpool,Liverpool,UnitedKingdom,2LiverpoolWomen’sNationalHealthServiceFoundationTrust,Liverpool, UnitedKingdom,3SchoolofHealthMedicine,LancasterUniversity,Lancaster,UnitedKingdom,4HealthPolicyandPractice,UniversityofEastAnglia,Norwich,United Kingdom,5DepartmentforWomen’sandChildren’sHealth,UniversityofLiverpool,Liverpool,UnitedKingdom Abstract Background: Social deprivation is associated with higher rates of preterm birth and subsequent infant mortality. Our objectivewastoidentifyriskfactorsforpretermbirthintheUK’slargestmaternityunit,withaparticularfocusonsocial deprivation,andrelatedfactors. Methodology/PrincipalFindings:Retrospectivecohortstudyof39,873womeninLiverpool,UK,from2002–2008.Singleton pregnancies were stratified into uncomplicated low risk pregnancies and a high risk group complicated by medical problems. Multiple logistic regression, and generalized additive models were used to explore the effect of covariates includingareadeprivation,smokingstatus,BMI,parityandethnicityontheriskofpretermbirth(34+0weeks).Inthelowrisk group, preterm birth rates increased with deprivation, reaching 1.6% (CI95 1.4 to 1.8) in the most deprived quintile; the unadjustedoddsratiocomparinganindividualinthemostdeprivedquintile,tooneintheleastdeprivedquintilewas1.5 (CI95 1.2to1.9).Beingunderweightandsmokingwerebothindependentlyassociatedwithpretermbirthinthelowrisk group,andadjustingforthesefactorsexplainedtheassociationbetweendeprivationandpretermbirth.Pretermbirthwas five times more likely in the high risk group (RR 4.8 CI95 4.3 to 5.4), and there was no significant relationship with deprivation. Conclusions:Deprivationhassignificantimpactonpretermbirthratesinlowriskwomen.Therelationshipbetweenlow socio-economic status andpreterm births appears to be relate