The risk factors of preterm birth: A multicentre case-control survey in China in 2018

Yi-Jie Zhang; Jieru Shen; Sam Bill Lin; Chengqiu Lu; Hong Jiang; Yi Sun; Xiuyong Cheng; Huaiyan Wang; Shudong Cui; Xiuqin Liu; Lie Huang; Xinzhu Lin; Guoying Zhao; Ling Yang; Chao Chen

doi:10.1111/jpc.16002

The risk factors of preterm birth: A multicentre case-control survey in China in 2018

J Paediatr Child Health. 2022 Aug;58(8):1396-1406. doi: 10.1111/jpc.16002. Epub 2022 May 7.

Authors

Yi-Jie Zhang¹, Jieru Shen¹, Sam Bill Lin¹, Chengqiu Lu², Hong Jiang³, Yi Sun⁴, Xiuyong Cheng⁵, Huaiyan Wang⁶, Shudong Cui⁷, Xiuqin Liu⁸, Lie Huang⁹, Xinzhu Lin¹⁰, Guoying Zhao¹¹, Ling Yang¹², Chao Chen^{1

13}

Affiliations

¹ Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
² Division of Neonatology, Gynecology and Obstetrics Hospital of Fudan University, Shanghai, China.
³ Department of Neonatology, Affiliated Hospital of Qingdao University, Qingdao, China.
⁴ Department of Neonatology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
⁵ Department of Neonatology, Zhengzhou University First Affiliated Hospital, Zhengzhou, China.
⁶ Department of Neonatology, Chang Zhou Shi Fu You Bao Jian Yuan, Changzhou, China.
⁷ Department of Neonatology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China.
⁸ Department of Neonatology, Jining No 1 People's Hospital, Jining, China.
⁹ Department of Neonatology, The First People's Hospital of Yinchuan, Yingchuan, China.
¹⁰ Department of Neonatology, Xiamen Maternal and Child Health Care Hospital, Xiamen, China.
¹¹ Department of Neonatology, Binzhou Medical University Hospital, Binzhou, China.
¹² Department of Neonatology, Hainan Women and Children's Medical Center, Haikou, China.
¹³ Key Laboratory of Neonatal Diseases, National Health Commission, Shanghai, China.

PMID: 35524688
DOI: 10.1111/jpc.16002

Abstract

Objectives: To investigate the risk profile of preterm birth (PTB) in 2018 in China.

Method: A prospective multicentre case-control study was conducted in 15 hospitals located in seven provinces throughout three geographical areas (the Eastern, South-Central and North-Western regions) in China. A total of 3147 preterm (<37⁺⁰ weeks) and 3147 term (37⁺⁰ to 41⁺⁶ weeks) live-birth mothers were included. Designed questionnaires were used to investigate maternal and fetal information. We calculated multivariable logistic regression and population attributable risk (PAR).

Results: Iatrogenic PTB accounted for 48.1% of preterm mothers. Multivariable analysis showed PTB was significantly associated with six categories of maternal and fetal factors, adverse life-style and psychological conditions (adjusted odds ratio (aOR) 2.063, 95% confidence interval (CI) 1.601-2.657) had the highest PAR% (60.1%). High school and below education level (PAR% = 25.8%), living in town or village (PAR% = 24.4%), low pregnant weight gain (PAR% = 16.8%), hypertensive disorders in pregnancy (aOR: 5.010, 95% CI: 4.039-6.216, PAR% = 15.3%), placental abnormality (aOR: 4.242, 95% CI: 3.454-5.211, PAR% = 14.1%) and multiple pregnancy (aOR: 10.990, 95% CI: 7.743-15.599, PAR% = 11.8%) were significantly associated with PTB with high PAR% value.

Conclusion: The main risk factors for PTB in China were placental abnormality, hypertensive disorders in pregnancy and multiple pregnancy. Adverse life-style and psychological conditions and socio-economic disadvantage had high public health significance.

Keywords: China; multicentre survey; population attributable risk; preterm birth; risk factors.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Case-Control Studies
China / epidemiology
Female
Humans
Hypertension, Pregnancy-Induced*
Infant, Newborn
Placenta
Pregnancy
Premature Birth* / epidemiology
Premature Birth* / etiology
Prospective Studies
Risk Factors
Surveys and Questionnaires