Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional study
Objective To determine if preterm birth, defined as gestational age <37 weeks, is lower for women living in counties with higher well-being, after accounting for known individual risk factors.Design Cross-sectional study of all US births in 2011.Participants We obtained birth data from the Na...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/4/e024143.full |
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| author | Jeph Herrin Harlan M Krumholz Carley Riley Brita Roy Erica Spatz Mark T Silvestri Anita Arora Kenneth P Kell Elizabeth Y Rula |
| author_facet | Jeph Herrin Harlan M Krumholz Carley Riley Brita Roy Erica Spatz Mark T Silvestri Anita Arora Kenneth P Kell Elizabeth Y Rula |
| author_sort | Jeph Herrin |
| collection | DOAJ |
| description | Objective To determine if preterm birth, defined as gestational age <37 weeks, is lower for women living in counties with higher well-being, after accounting for known individual risk factors.Design Cross-sectional study of all US births in 2011.Participants We obtained birth data from the National Center for Health Statistics which included 3 938 985 individuals.Main outcomes measures Primary outcome measure was maternal risk of preterm delivery by county; primary independent variable was county-level well-being as measured by the Gallup-Sharecare Well-Being Index (WBI).Results Women living in counties with higher population well-being had a lower rate of preterm delivery. The rate of preterm birth in counties in the lowest WBI quintile was 13.1%, while the rate of preterm birth in counties in the highest WBI quintile was 10.9%. In the model adjusted for maternal risk factors (age, race, Hispanic ethnicity, smoking status, timing of initiation of prenatal visits, multiparity, maternal insurance payer), the association was slightly attenuated with an absolute difference of 1.9% (95% CI 1.7% to 2.1%; p<0.001).Conclusions Pregnant women who live in areas with higher population well-being have lower risk of preterm birth, even after accounting for individual risk factors. |
| format | Article |
| id | doaj-art-9f618439d1d545b6a58e35eb9c047893 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-9f618439d1d545b6a58e35eb9c0478932025-02-12T00:35:09ZengBMJ Publishing GroupBMJ Open2044-60552019-05-019410.1136/bmjopen-2018-024143Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional studyJeph Herrin0Harlan M Krumholz1Carley Riley2Brita Roy3Erica Spatz4Mark T Silvestri5Anita Arora6Kenneth P Kell7Elizabeth Y Rula8Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA3 Yale-New Haven Hospital Center for Outcomes Research and Evaluation, New Haven, Connecticut, USA2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USASection of General Internal Medicine, Department of Medicine, Yale University, New Haven, Connecticut, USA4 Center for Outcomes Research and Evaluation, Yale-New Haven Health, New Haven, Connecticut, USA4 Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USADepartment of Internal Medicine, Section of General Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA6 Tivity Health, Nashville, Tennessee, USA7 Tivity Health, Franklin, Tennessee, USAObjective To determine if preterm birth, defined as gestational age <37 weeks, is lower for women living in counties with higher well-being, after accounting for known individual risk factors.Design Cross-sectional study of all US births in 2011.Participants We obtained birth data from the National Center for Health Statistics which included 3 938 985 individuals.Main outcomes measures Primary outcome measure was maternal risk of preterm delivery by county; primary independent variable was county-level well-being as measured by the Gallup-Sharecare Well-Being Index (WBI).Results Women living in counties with higher population well-being had a lower rate of preterm delivery. The rate of preterm birth in counties in the lowest WBI quintile was 13.1%, while the rate of preterm birth in counties in the highest WBI quintile was 10.9%. In the model adjusted for maternal risk factors (age, race, Hispanic ethnicity, smoking status, timing of initiation of prenatal visits, multiparity, maternal insurance payer), the association was slightly attenuated with an absolute difference of 1.9% (95% CI 1.7% to 2.1%; p<0.001).Conclusions Pregnant women who live in areas with higher population well-being have lower risk of preterm birth, even after accounting for individual risk factors.https://bmjopen.bmj.com/content/9/4/e024143.full |
| spellingShingle | Jeph Herrin Harlan M Krumholz Carley Riley Brita Roy Erica Spatz Mark T Silvestri Anita Arora Kenneth P Kell Elizabeth Y Rula Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional study BMJ Open |
| title | Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional study |
| title_full | Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional study |
| title_fullStr | Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional study |
| title_full_unstemmed | Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional study |
| title_short | Do pregnant women living in higher well-being populations in the USA experience lower risk of preterm delivery? A cross-sectional study |
| title_sort | do pregnant women living in higher well being populations in the usa experience lower risk of preterm delivery a cross sectional study |
| url | https://bmjopen.bmj.com/content/9/4/e024143.full |
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