Factores socioeconómicos asociados al parto pretérmino. Resultados del proyecto EUROPOP en el Estado español

Escribà-Agüir, V.; Clemente, I.; Saurel-Cubizolles, M.J.

doi:10.1016/S0213-9111(01)71511-7

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Objetivos

Los objetivos del presente trabajo son determinar el efecto de los factores de riesgo sociales, personales y médicos sobre el total de partos pretérmino. Así mismo, se estudia si el efecto de estos factores de riesgo se mantiene según el tipo de parto pretérmino (moderado frente a muy pretérmino) o bien según el modo de inicio del parto pretérmino (espontáneo frente a indicado).

Métodos

Se presentan los resultados del centro colaborador español del estudio de casos y controles multicéntrico europeo EUROPOP (European Program of Occupational Risks and Pregnancy Outcome). Se han incluido todos los partos pretérmino (529), es decir entre 22 y 36 semanas completas de gestación, y 788 partos de 37 o más semanas de gestación (grupo control). Las variables explicativas se dividen en factores sociales, características personales y factores médicos. Se ha llevado a cabo un análisis univariante y multivariante por medio del ajuste de modelos de regresión logística.

Resultados

El riesgo del parto muy pretérmino es mayor en las mujeres de edad superior a 34 años, OR (ajustada), 2,53 (1,42-4,52); con bajo nivel de estudios, OR (ajustada), 1,79 (1,07-2,98); en las primíparas o multigestas con antecedentes de abortos del primer trimestre, OR (ajustada), 1,86 (1,13-3,04), y en las multigestas con antecedentes de parto pretérmino o abortos del segundo trimestre, OR (ajustada), 5,53 (2,97-10,35). En el caso del parto pretérmino moderado se encuentra la misma tendencia. La probabilidad de presentar un parto pretérmino espontáneo es superior en las madres de más de 34 años, OR (ajustada), 1,51 (1,01-2,26); con bajos ingresos familiares, OR (ajustada), 1,75 (1,07-2,88), y en las multigestas con antecedentes de parto pretérmino o abortos de segundo trimestre, OR (ajustada), 2,96 (1,86-4,71). En el caso de parto pretérmino indicado los resultados son similares.

Conclusión

Persisten diferencias sociales en el riesgo de parto pretérmino moderado y muy pretérmino. No se evidencian diferencias entre los factores de riesgo según el tipo de parto pretérmino: espontáneo o indicado.

Palabras clave:

Embarazo

Factores socioeconómicos

Historia obstétrica

Estudio de casos y controles

Summary

Objectives

The objectives of this paper were to analyse the effect of social, personal and medical risk factors on preterm birth (moderate versus very preterm) or on two preterm birth groups (spontaneous versus indicated).

Methods

Results from the Spanish collaborating centre of the European multicentre case-control study EUROPOP (European Program of Occupational Risks and Pregnancy Outcome) are presented. All preterm births (529) between 22 and 36 completed weeks of amenorrhea and 788 births of 37 or more completed weeks of amenorrhea (control group) are included. Explicative variables are divided in social, personal and medical factors. A univariate and multivariate analysis by means of a logistic regression were carried out.

Results

Very preterm birth risk was higher for women over 34 years, adjusted OR: 2.53 (1.42-4.52), with lower educational level, adjusted OR: 1.79 (1.07-2.98), for primigravid women or multigravid women with only first trimestre abortion, adjusted OR: 1.86 (1.13-3.04), and for multigravid women with previous preterm birth or second trimestre abortion, adjusted OR: 5.53 (2.97-10.35). A similar trend was observed for moderate preterm birth. Probability of spontaneous preterm birth was higher for mother over 34 years, adjusted OR: 1.51 (1.01-2.26), with lower income, adjusted OR: 1.75 (1.07-2.88) and for multigravid women with previous preterm birth or second trimestre abortion, adjusted OR: 2.96 (1.86-4.71). Results were similar for indicated preterm birth.

Conclusion

Social differences were found to be related to moderate and very preterm birth. No differences were observed between risk factors and kind of preterm birth: spontaneous or indicated.

Key words:

Pregnancy

Socioeconomic status

Obstetric history

Case-controls study

Spain

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