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Deprivation and Infection Among Spontaneous Very Preterm Births

From the Department of Health Sciences, University of Leicester, Leicester, United Kingdom.

OBJECTIVE: To explore the relationship between infection and socioeconomic deprivation among mothers of spontaneous very preterm infants to contribute to the understanding of the deprivation gap in the incidence of very preterm birth.

METHODS: We used comprehensive data from a large retrospective study of very preterm birth in a U. K. health region (representing approximately 1 in 12 U.K. births) between 1994 and 2005. We report the relationship between fetal or maternal infection before birth and deprivation quintile of all singleton live births at 22 0/7 to 32 6/7 weeks of gestation associated with spontaneous onset of labor.

RESULTS: Overall, 24% of the 4,987 spontaneous very preterm singleton births had recorded evidence of maternal or fetal infection. Rates of infection increased significantly with increasing deprivation. Spontaneous very preterm births to mothers from the most deprived quintile were at 43% increased odds of being associated with infection compared with those from the least deprived quintile (odds ratio 1.43, 95% confidence interval 1.13–1.80) after adjusting for gestation, year of birth, and mother’s age.

CONCLUSION: Spontaneous very preterm births to mothers from more deprived areas are more likely to be associated with infection before birth.

LEVEL OF EVIDENCE: II

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