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KMID : 0361720060170020173
Korean Journal of perinatology
2006 Volume.17 No. 2 p.173 ~ p.180
Regional Differences in Pre term Birth Rates: Based on 2003 Birth Certificate Data
Park Sang-Hwa

Ku Seung-Yup
Kim Seok-Hyun
Lee Jung-Ryeol
Choi Young-Sik
Moon Shin-Yong
Moon Shin-Yong
Ku Seung-Yup
Kim Seok-Hyun
Abstract
Objective: Preterm birth is one of the leading causes of infant death and a major contributor to early childhood morbidity. It has been recognized that numerous factors are responsible for the development of preterm delivery. Among these factors, environmental influences have been demonstrated in many studies. The purpose of this study was to analyze the regional variations of preterm birth rates and to reveal the association between environmental influences and preterm birth.

Methods: Based on the 2003 birth certificate data from National Statistical Office, we analyzed 475,680 singleton births with certain gestational age at delivery of seven metropolitan cities and nine provinces in Korea. Multiple logistic regression analysis was used to examine the relationship between preterm birth and regional differences, adjusting for other risk factors such as maternal age, sex of infants, order of the babies and mother¡¯s education.

Results: The rate of preterm delivery was 3.8 percent. The highest preterm birth rate was observed in Daegu metropolitan city (4.2%), and the lowest in Jeonbuk province (3.2%). Risk of preterm birth was higher in mothers with younger (<20 years) and older (> or =30 years) ages, with lower educational levels, and in male infants. There was a significant increase in the risk of preterm birth in Daegu metropolitan city (odds ratio (OR) 1.32, 95% confidence interval (CI), 1.19~1.47), Gangwon province (OR 1.27, 95% CI, 1.13~1.43), Gyeongbuk province (OR 1.26, 95% CI, 1.14~1.40), Jeonnam province (OR 1.22, 95% CI, 1.09~1.37), Busan metropolitan city (OR 1.21, 95% CI, 1.09~1.34), Ulsan metropolitan city (OR 1.19, 95% CI, 1.05~1.36), and Gyeonggi province (OR 1.15, 95% CI, 1.05~1.26) as compared with the incidence of preterm birth in Jeonbuk province.

Conclusion: Regional variations of preterm birth rate was observed among metropolitan cities and provinces in Korea. Further larger scale studies are necessary to determine more specific factors associated with these differences.
KEYWORD
Preterm birth, Regional differences, Environmental impacts, Risk factors, Birth certificate data
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