Contribution of Maternal Age Distribution to Incidence of Preterm Birth; 1997~99 and 2012~14 Singleton Birth Certificated Data of Korea

ABSTRACT

PURPOSE: The objective of the study was to compare contribution of maternal age to preterm birth (PTB) rates between 1997~99 and 2012~14. METHODS: We used 1997~99 (1,872,720 births) and 2012~14 (1,280,348 births) singleton birth certificated data of Korea Statistics excluding multiple birth and extra-marital birth cases. We decomposed the contributions of age-specific PTB rates and maternal age distribution (Kitagawa's decomposition method) to overall PTB rates during the period. Odds ratio (OR) and 95% confidence intervals were calculated from logistic regression to describe the secular trend of PTB rate by birth year and maternal age. RESULTS: The incidence of PTB increased 1.5 times, from 3.0 percent to 4.6 percent, during 1997~2014. After adjustment by logistic regression for infantile sex, parity and maternal age, the odds ratio of PTB in birth year of 2012~14 was 1.38 (95% confidence interval 1.36~1.39), compared with incidence of PTB in 1997~99. During the period, PTB rates increased 1.79 times in women aged 20~24 years and 25~29 years (OR 1.56), whereas rates remained stable in women aged 35 years and older (OR range from 1.08 to 1.13). 87.5% of the overall increase in the PTB rates was attributable to the increase in the proportion of women aged 30~34 years, but these age group accounted for only a small portion of the increase in PTB rates (OR 1.27). CONCLUSION: The remainder of the total increment in the PTB rates during the period was explained by increase the proportion of women aged 30~34 years. There was a need to close attention in this area to understand the contributing factors to the secular trend of PTB rates.