TY - JOUR
T1 - Exploring educational disparities in risk of preterm delivery
T2 - a comparative study of 12 European birth cohorts
AU - Poulsen, Gry
AU - Strandberg-Larsen, Katrine
AU - Mortensen, Laust
AU - Barros, Henrique
AU - Cordier, Sylvaine
AU - Correia, Sofia
AU - Danileviciute, Asta
AU - van Eijsden, Manon
AU - Fernández-Somoano, Ana
AU - Gehring, Ulrike
AU - Grazuleviciene, Regina
AU - Hafkamp-de Groen, Esther
AU - Henriksen, Tine Brink
AU - Jensen, Morten Søndergaard
AU - Larrañaga, Isabel
AU - Magnus, Per
AU - Pickett, Kate
AU - Raat, Hein
AU - Richiardi, Lorenzo
AU - Rouget, Florence
AU - Rusconi, Franca
AU - Stoltenberg, Camilla
AU - Uphoff, Eleonora P
AU - Vrijkotte, Tanja G M
AU - Wijga, Alet H
AU - Vrijheid, Martine
AU - Osler, Merete
AU - Andersen, Anne-Marie Nybo
N1 - © 2015 John Wiley & Sons Ltd.
PY - 2015/5
Y1 - 2015/5
N2 - BACKGROUND: An association between education and preterm delivery has been observed in populations across Europe, 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 European cohorts from Denmark, England, France, Lithuania, the Netherlands, Norway, Italy, Portugal, and Spain. 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 (CIs).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 Europe. 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.
AB - BACKGROUND: An association between education and preterm delivery has been observed in populations across Europe, 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 European cohorts from Denmark, England, France, Lithuania, the Netherlands, Norway, Italy, Portugal, and Spain. 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 (CIs).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 Europe. 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.
U2 - 10.1111/ppe.12185
DO - 10.1111/ppe.12185
M3 - Article
C2 - 25808200
SN - 0269-5022
VL - 29
SP - 172
EP - 183
JO - Paediatric and Perinatal Epidemiology
JF - Paediatric and Perinatal Epidemiology
IS - 3
ER -