title: Disparities and relative risk ratio of preterm birth in six Central and Eastern European centers.
abstract: OBJECTIVE
  To identify characteristic risk factors of preterm birth in Central and Eastern Europe and explore the differences from other developed countries.
  
  
  METHODS
  Data on 33,794 term and 3867 preterm births (<37 wks.) were extracted in a retrospective study between January 1, 2007 and December 31, 2009. The study took place in 6 centers in 5 countries: Czech Republic, Hungary (two centers), Romania, Slovakia, and Ukraine. Data on historical risk factors, pregnancy complications, and special testing were gathered. Preterm birth frequencies and relevant risk factors were analyzed using Statistical Analysis System (SAS) software.
  
  
  RESULTS
  All the factors selected for study (history of smoking, diabetes, chronic hypertension, current diabetes, preeclampsia, progesterone use, current smoking, body mass index, iron use and anemia during pregnancy), except the history of diabetes were predictive of preterm birth across all participating European centers. Preterm birth was at least 2.4 times more likely with smoking (history or current), three times more likely with preeclampsia, 2.9 times more likely with hypertension after adjusting for other covariates. It had inverse relationship with the significant predictor body mass index, with adjusted risk ratio of 0.8 to 1.0 in three sites. Iron use and anemia, though significant predictors of preterm birth, indicated mixed patterns for relative risk ratio.
  
  
  CONCLUSIONS
  Smoking, preeclampsia, hypertension and body mass index seem to be the foremost risk factors of preterm birth. Implications of these factors could be beneficial for design and implementation of interventions and improve the birth outcome.
authors.affiliation: Chander P Arora, International Research and Innovation Management Program, Cedars-Sinai Medical Center, 6420 Wilshire Blvd. Suite # 301, Los Angeles, California 90048, USA, arora@cshs.org.
authors.forename: Chander P
authors.initials: CP
authors.lastname: Arora
authors.forename: Marian
authors.initials: M
authors.lastname: Kacerovsky
authors.forename: Balazs
authors.initials: B
authors.lastname: Zinner
authors.forename: Tibor
authors.initials: T
authors.lastname: Ertl
authors.forename: Iuliana
authors.initials: I
authors.lastname: Ceausu
authors.forename: Igor
authors.initials: I
authors.lastname: Rusnak
authors.forename: Serhiy
authors.initials: S
authors.lastname: Shurpyak
authors.forename: Meenu
authors.initials: M
authors.lastname: Sandhu
authors.forename: Calvin J
authors.initials: CJ
authors.lastname: Hobel
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Dumesic
authors.forename: Sandor G
authors.initials: SG
authors.lastname: Vari
mesh_terms: D000328:Adult; D001723:Birth Rate; D015992:Body Mass Index; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology