title: Delivery at Term: Impact of University Education by Week of Gestation.
abstract: OBJECTIVE
  Data on risk factors for early term delivery are scant despite greater complications in infants born at 37 and 38 weeks' gestation. We determined the probability of delivery by gestational week at term according to level of maternal education, an established risk factor for preterm birth.
  
  
  METHODS
  We analyzed 2 319 697 live singleton births at term (≥37 weeks) in Quebec from 1981 to 2010. We estimated hazard ratios with 95% confidence intervals (CI) of delivery according to level of maternal education, adjusting for individual characteristics. The main outcome measure was the probability of delivery at term by week of gestation for women with university education versus high school education.
  
  
  RESULTS
  Early term birth at 37 and 38 weeks of gestation was less common for university-educated women (23.1%) than for high school-educated women (25.8%; P < 0.001). Compared with women with a high school education, university-educated women had a 15% lower probability of delivery at 37 to 38 weeks (95% CI: 0.84 to 0.86), a 4% lower probability of delivery at 39 weeks (95% CI: 0.96 to 0.97) and a 2% lower probability of delivery at 40 weeks (95% CI: 0.97 to 0.98). University-educated women were, however, more likely to deliver at 41 weeks.
  
  
  CONCLUSIONS
  A higher level of education was associated with longer duration of pregnancy at term. Women who were university-educated had a lower chance of delivery at 37, 38, 39, and even 40 weeks of gestation. Clinicians should be aware that women with lower levels of education are more likely to deliver earlier at term.
authors.affiliation: Institut national de santé publique du Québec, Montreal QC; University of Montreal Hospital Research Centre, Montreal QC; Department of Social and Preventive Medicine, University of Montreal, Montreal QC.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Auger
authors.affiliation: Sainte-Justine Hospital Research Centre, Montreal QC.
authors.forename: Line
authors.initials: L
authors.lastname: Leduc
authors.affiliation: Department of Obstetrics and Gynecology, McGill University, Montreal QC.
authors.forename: Ashley I
authors.initials: AI
authors.lastname: Naimi
authors.affiliation: University of Montreal Hospital Research Centre, Montreal QC; Sainte-Justine Hospital Research Centre, Montreal QC.
authors.forename: William D
authors.initials: WD
authors.lastname: Fraser
mesh_terms: D000328:Adult; D004522:Educational Status; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology*; D012307:Risk Factors; D047929:Term Birth; D055815:Young Adult
keywords: Educational status; gestational age; pregnancy; term birth