Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: May 9, 2023
Date Accepted: May 14, 2024
Spatio-temporal characteristics and risk factors of all and severity-specific preterm births in South China, 2014-2021: a large population-based study
ABSTRACT
Background:
The incidence of preterm infants is increasing worldwide, which places a heavy burden on the socio-economic situation.
Objective:
To calculate the incidence of preterm birth, very preterm birth, and extremely preterm birth, and describe the spatiotemporal distribution of preterm birth.
Methods:
Data was obtained from the Guangdong Provincial Maternal and Child Health Information System from January 1, 2014 to December 31, 2021, where infants gestation in the range of 24 to 42 weeks. The main outcome measures were changes in different types of PTB rates during the study. We also explored the correlation between the incidence of preterm birth and gross domestic product (GDP) per capita, and analyzed the risk factors for the occurrence of preterm birth.
Results:
Data from 13,256,743 live births were included for study analysis. There were 754,268 preterm infants and 12,502,475 full-term infants. The incidences of preterm birth, very preterm birth and extremely preterm birth were 5.69 (per 100 births), 4.46 (per 1,000 births) and 4.83 (per 10,000 births), respectively. The overall incidence of preterm birth increased from 5.12% in 2014 to 6.38% in 2021. The incidence of extremely preterm birth increased from 4.10 (per 10,000 births) to 8.09 (per 10,000 births) from 2014 to 2021. The incidence of preterm infants is positively correlated with GDP per capita. In addition, adjusted ORs showed that advanced maternal age, multiple pregnancies, and male infants were risk factors for the preterm infants, while autumn childbirth was a protective factor for the development of preterm infants.
Conclusions:
The rate of preterm birth in South China showed an increasing trend, which was inseparable from the improvement of the treatment ability of high-risk pregnant women and severe newborns. Under the liberalization of the three-child policy in China, with the transient increase of advanced maternal age and multiple pregnancies, the risk of preterm birth was also increased. It is necessary to increase public health investment to avoid the risk factors of preterm birth in order to reduce the burden of preterm birth on the social economy.
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