title: Medical and sociodemographic risk factors for preterm birth in a French Caribbean population of African descent.
abstract: There appears to be an incompressible high rate of preterm births among populations of African origin irrespective of their geographic location. The objective of this study was to assess the risk factors for preterm birth in a French Caribbean population of African descent, offered medical care comparable to that on the French mainland, but presenting a higher rate of preterm birth. The study was based on a birth cohort at maternity hospitals in Guadeloupe (French West Indies) including 911 singleton pregnancies enrolled during their third trimester check-up visits. Associations between risk factors and the risk of preterm delivery (spontaneous and induced) were assessed using a multivariate Cox model. In addition, prevalences of sociodemographic and medical factors in Guadeloupe were compared with those on the French mainland. 144 women (15.8 %) delivered preterm, medically induced in 52 %. Women delivering preterm were more often over 35 years old (37 %), single (54 %), and had higher prevalence of prior preterm birth (20 %), prior miscarriage (37 %), lupus (3 %), asthma (14 %), gestational hypertension (26 %), gestational diabetes (13 %) and urinary tract infection (24 %) than women with term births. In the whole cohort, these risk factors were also more frequent than in mainland France. Our results suggest highly prevalent medical risk factors for preterm births in Guadeloupe. This observation combined with specific social risk factors (older maternal age, single living) less frequent on the French mainland probably explains a large part of a higher prevalence of preterm births in this population despite similar medical provision.
authors.affiliation: Epidemiological Research on Environment, Reproduction and Development, Institut National de la Santé et de la Recherche Médicale (INSERM), U1085, Campus de Beaulieu, 35042 Rennes cedex, France. florence.rouget@univ-rennes1.fr
authors.forename: F
authors.initials: F
authors.lastname: Rouget
authors.forename: J
authors.initials: J
authors.lastname: Lebreton
authors.forename: P
authors.initials: P
authors.lastname: Kadhel
authors.forename: C
authors.initials: C
authors.lastname: Monfort
authors.forename: F
authors.initials: F
authors.lastname: Bodeau-Livinec
authors.forename: E
authors.initials: E
authors.lastname: Janky
authors.forename: L
authors.initials: L
authors.lastname: Multigner
authors.forename: S
authors.initials: S
authors.lastname: Cordier
mesh_terms: D000328:Adult; D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D019430:Guadeloupe / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology*; D047928:Premature Birth / Q000208:ethnology*; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult