Document Detail

Rising preterm birth rates, 1989-2004: changing demographics or changing obstetric practice?
MedLine Citation:
PMID:  22177849     Owner:  NLM     Status:  MEDLINE    
Preterm birth rates are higher in the United States than in most industrialized countries, and have been rising steadily. Some attribute these trends to changing demographics, with more older mothers, more infertility, and more multiple births. Others suggest that changes in obstetrics are behind the trends. We sought to determine what the preterm birth rate in 2004 would have been if demographic factors had not changed since 1989. We examined complete US birth certificate files from 1989 and 2004 and used logistic regression models to estimate what the 2004 preterm birth rates (overall, spontaneous, and medically induced) would have been if maternal age, race, nativity, gravidity, marital status, and education among childbearing women had not changed since 1989. While the overall preterm births increased from 11.2% to 12.8% from 1989 to 2004, medically induced rates increased 94%, from 3.4% to 6.6%, and spontaneous rates declined by 21%, from 7.8% to 6.2%. Had demographic factors in 2004 been what they were in 1989, the 2004 rates would have been almost identical. Changes in multiple births accounted for only 16% of the increase in medically induced rates. Our analysis suggests that the increase in preterm births is more likely due primarily to changes in obstetric practice, rather than to changes in the demographics of childbearing. Further research should examine the degree to which these changes in obstetric practice affect infant morbidity and mortality.
Tyler J VanderWeele; John D Lantos; Diane S Lauderdale
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-12-06
Journal Detail:
Title:  Social science & medicine (1982)     Volume:  74     ISSN:  1873-5347     ISO Abbreviation:  Soc Sci Med     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-16     Completed Date:  2012-05-14     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  8303205     Medline TA:  Soc Sci Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  196-201     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
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MeSH Terms
Birth Rate / trends*
Continental Population Groups / statistics & numerical data
Delivery, Obstetric / statistics & numerical data*
Educational Status
Labor, Induced / statistics & numerical data
Marital Status / statistics & numerical data
Maternal Age
Middle Aged
Pregnancy Outcome / epidemiology*
Pregnancy, Multiple
Premature Birth / epidemiology*
Socioeconomic Factors
United States
Young Adult
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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