Korean J Perinatol.  2006 Jun;17(2):173-180.

Regional Differences in Preterm Birth Rates: Based on 2003 Birth Certificate Data

• Park SH
• Lee JR
• Choi YS
• Ku SY
• Moon SY
• Kim SH

Abstract

OBJECTIVE
Preterm birth is one of the leading causes of infant death and a major contributor to early childhood morbidity. It has been recognized that numerous factors are responsible for the development of preterm delivery. Among these factors, environmental influences have been demonstrated in many studies. The purpose of this study was to analyze the regional variations of preterm birth rates and to reveal the association between environmental influences and preterm birth.
METHODS
Based on the 2003 birth certificate data from National Statistical Office, we analyzed 475,680 singleton births with certain gestational age at delivery of seven metropolitan cities and nine provinces in Korea. Multiple logistic regression analysis was used to examine the relationship between preterm birth and regional differences, adjusting for other risk factors such as maternal age, sex of infants, order of the babies and mother's education.
RESULTS
The rate of preterm delivery was 3.8 percent. The highest preterm birth rate was observed in Daegu metropolitan city (4.2%), and the lowest in Jeonbuk province (3.2%). Risk of preterm birth was higher in mothers with younger (<20 years) and older (> or =30 years) ages, with lower educational levels, and in male infants. There was a significant increase in the risk of preterm birth in Daegu metropolitan city (odds ratio (OR) 1.32, 95% confidence interval (CI), 1.19~1.47), Gangwon province (OR 1.27, 95% CI, 1.13~1.43), Gyeongbuk province (OR 1.26, 95% CI, 1.14~1.40), Jeonnam province (OR 1.22, 95% CI, 1.09~1.37), Busan metropolitan city (OR 1.21, 95% CI, 1.09~1.34), Ulsan metropolitan city (OR 1.19, 95% CI, 1.05~1.36), and Gyeonggi province (OR 1.15, 95% CI, 1.05~1.26) as compared with the incidence of preterm birth in Jeonbuk province.
CONCLUSION
Regional variations of preterm birth rate was observed among metropolitan cities and provinces in Korea. Further larger scale studies are necessary to determine more specific factors associated with these differences.

Keyword

Preterm birth; Regional differences; Environmental impacts; Risk factors; Birth certificate data

MeSH Terms

Birth Certificates*
Busan
Daegu
Education
Gangwon-do
Gestational Age
Gyeonggi-do
Gyeongsangbuk-do
Humans
Incidence
Infant
Jeollabuk-do
Jeollanam-do
Korea
Logistic Models
Male
Maternal Age
Mothers
Parturition*
Premature Birth*
Risk Factors
Ulsan