Decomposing of Socioeconomic Factors Inequality in Preterm Birth, Results of a Cohort Study Based on Concentration Index Approach

Authors

1 Department of Midwifery, Faculty of Nursing and Midwifery, Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.

2 Department of Midwifery, School of Nursing and Midwifery, Ayatollah Taleghani Hospital, Ilam University of Medical sciences, Ilam, Iran.

3 Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran.

Abstract

Introduction: Preterm labor is an important factor for neonatal morbidity and mortality. In the present study, we aimed to investigate the effects of Socioeconomic Status (SES) on preterm birth and also decomposing of main inequalities determinants on preterm birth.
Material and methods: In a Cohort study, followed up 458 pregnant women in Ilam, Iran, in 2017 from 20th of Gestational Age to delivery. In order to exchange information between researcher and participants, a code inserted in the prenatal care booklet of each participant. The concentration index (CI) was used to determine of inequality. Inequality index was decomposed to find out main sources of inequality in preterm infants. Distributive Analysis Stata Package was used for estimating CI.
Result: Of 458 participants, 12% were preterm labor. also, 219 (47.8%) were male. Also ratio of preterm labor was more observed in 20-31 mothers' age group (p < 0.001), and housewife's (p=0.037) and in lower socioeconomic status (p < 0.001). The important socioeconomic contributor's in inequality were mother age (p=0.008), father age (p=0.005), father education (p=0.003), and father's job (p < 0.001). The main sources of inequality were mother age (8%), father age (3%), father education (5%), and father's job (25%).
Conclusion: According to our results preterm birth is significantly more concentrated among disadvantaged mothers. Some SES, including the mother's age, father age, father education and father job are important preterm inequality in Iranian mothers that policy makers more concentrated maternal and child health programs to these sensitive groups.

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