Spontaneous very preterm birth in relation to social class, and smoking: a temporal-spatial analysis of routinely collected data in Aberdeen, Scotland (1985–2010)

Stephen J. McCall* (Corresponding Author), David R. Green, Gary J. MacFarlane, Sohinee Bhattacharya

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Objective: To examine trends of spontaneous very preterm birth (vPTB) and its relationship with maternal socioeconomic status and smoking.
Methods: This was a population-based cohort study in Aberdeen Maternity Hospital, UK. The cohort was restricted to spontaneous singleton deliveries occurring in Aberdeen from 1985-2010. The primary outcome was very preterm birth which was defined as <32 weeks gestation and the comparison group was deliveries ≥37 weeks of gestation. The main exposures were parental Social Class based on Occupation, Carstairs’ deprivation index and smoking during pregnancy. Logistic regression was used to estimate the association between vPTB and the exposures.
Results: There was an increased likelihood of vPTB in those with unskilled-occupations compared to professional-occupations [aOR:2.77 (95%CI:1.54-4.99)], in those who lived in the most deprived areas compared to those in the most affluent [aOR:1.74 (95%CI:1.36-2.21)] and in women who smoked compared to those who did not [aOR: 2.16 (95%CI: 1.27-3.67)]. The association with Carstairs index was no longer statistically significant when restricted to smokers but remained significant when restricted to non-smokers.
Conclusion: The strongest risk factor for vPTB was maternal smoking while socioeconomic deprivation showed a strong association in non-smokers. Smoking cessation interventions may reduce vPTB. Modifiable risk factors should be explored in deprived areas.
Original languageEnglish
Article numberfdz042
JournalJournal of Public Health
Early online date24 May 2019
DOIs
Publication statusE-pub ahead of print - 24 May 2019

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Keywords

  • neonates
  • smoking
  • Social determinants

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