Neighborhood deprivation and preterm birth in Plymouth, UK.
OBJECTIVE
To assess the relationship between neighborhood deprivation and the preterm birth rate in Plymouth, UK, using routinely collected data from a clinical information system.


METHODS
We used a clinic-based prospective case register study of all births in Plymouth UK between 1 January 1996 and 31 December 1997 combined with indices of neighborhood deprivation to assess the relationship between neighborhood deprivation and the preterm birth rate. Areas (n = 43) were classified according to the Townsend index, measuring material deprivation. Preterm births were compared with term births.


RESULTS
The incidence of singleton preterm birth was 5.3% (95% confidence interval (CI) 4.6, 6.0). The singleton preterm birth rate increased with Townsend material deprivation score. Crude rates increased by 31% (relative risk (RR) (95% CI) 1.31 (0.94, 1.84), p = 0.056) among those living in the most deprived areas compared to those living in the least deprived areas. A stepwise binary logistic regression model showed an increase in the relative risk of preterm birth of 7% for every unit increase in the Townsend material deprivation score (RR (95% CI) 1.07 (1.03, 1.11)).


CONCLUSIONS
Neighborhood deprivation is related to preterm birth. Examining individual and neighborhood factors together may increase understanding of the complex causes of preterm birth.
Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran. janghorbani@yahoo.com
Mohsen
M
Janghorbani
Elizabeth
E
Stenhouse
Ann
A
Millward
Raymond B
RB
Jones
D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D011446:Prospective Studies; D011610:Psychosocial Deprivation; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012923:Social Class; D011795:Surveys and Questionnaires