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Article Dans Une Revue Paediatric and Perinatal Epidemiology Année : 2015

Exploring educational disparities in risk of preterm delivery: a comparative study of 12 European birth cohorts

Gry Poulsen
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Katrine Strandberg-Larsen
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Laust Mortensen
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Sofia Correia
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Asta Danileviciute
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Manon Van Eijsden
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Ulrike Gehring
Esther Hafkamp-de Groen
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Tine Brink Henriksen
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Morten Søndergaard Jensen
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Isabel Larrañaga
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Kate Pickett
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Franca Rusconi
Camilla Stoltenberg
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Eleonora P. Uphoff
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Tanja G. M. Vrijkotte
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Alet H. Wijga
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Martine Vrijheid
Merete Osler
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Anne-Marie Nybo Andersen
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Résumé

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.

Dates et versions

hal-01146842 , version 1 (29-04-2015)

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Gry Poulsen, Katrine Strandberg-Larsen, Laust Mortensen, Henrique Barros, Sylvaine Cordier, et al.. Exploring educational disparities in risk of preterm delivery: a comparative study of 12 European birth cohorts. Paediatric and Perinatal Epidemiology, 2015, 29 (3), pp.172--183. ⟨10.1111/ppe.12185⟩. ⟨hal-01146842⟩
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