Open Access Research article

Neighbourhood deprivation and very preterm birth in an English and French cohort

Mercedes Bonet12*, Lucy K Smith3, Hugo Pilkington14, Elizabeth S Draper3 and Jennifer Zeitlin12

Author Affiliations

1 INSERM, UMR S953, Epidemiological Research Unit on Perinatal Health and Women’s and Childrens’ Health, Paris, France

2 UPMC, Univ Paris 06, Paris, France

3 Department of Health Sciences, University of Leicester, Leicester, LE1 6TP, UK

4 Department of Geography, University Paris 8 Vincennes-Saint Denis, Saint Denis, France

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BMC Pregnancy and Childbirth 2013, 13:97  doi:10.1186/1471-2393-13-97

Published: 25 April 2013

Abstract

Background

Social factors affect the risk of very preterm birth and may affect subsequent outcomes in those born preterm. We assessed the influence of neighbourhood socio-economic characteristics on the risk and outcomes of singleton very preterm birth (<32 weeks of gestation) in two European regions with different health systems.

Methods

Live births (n=1118) from a population-based cohort of very preterm infants in 2003 in Trent (UK) and Ile-de-France (France) regions were geocoded to their neighbourhood census tracts. Odds ratios for very preterm singleton birth by neighbourhood characteristics (unemployment rate, proportion manual workers, proportion with high school education only, non home ownership) were computed using infants enumerated in the census as a control population. The impact of neighbourhood variables was further assessed by pregnancy and delivery characteristics and short term infant outcomes.

Results

Risk of very preterm singleton birth was higher in more deprived neighbourhoods in both regions (OR between 2.5 and 1.5 in the most versus least deprived quartiles). No consistent associations were found between neighbourhood deprivation and maternal characteristics or health outcomes for very preterm births, although infants in more deprived neighbourhoods were less likely to be breastfed at discharge.

Conclusions

Neighbourhood deprivation had a strong consistent impact on the risk of singleton very preterm birth in two European regions, but did not appear to be associated with maternal characteristics or infant outcomes. Differences in breastfeeding at discharge suggest that socio-economic factors may affect long term outcomes.

Keywords:
Very preterm infants; Social inequalities; Europe; Census data