Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis
Abstract Background Although highly heterogeneous among countries, the incidence rates of low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA) have been increasing globally over the past two decades. To better understand the cause of these secular trends, this study aimed...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-07-01
|
| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-023-05799-9 |
| _version_ | 1797769295275491328 |
|---|---|
| author | Rongfei Zhou Huiting Yu Naisi Qian Shan Jin Renzhi Cai Lei Chen Chunfang Wang Fan Wu |
| author_facet | Rongfei Zhou Huiting Yu Naisi Qian Shan Jin Renzhi Cai Lei Chen Chunfang Wang Fan Wu |
| author_sort | Rongfei Zhou |
| collection | DOAJ |
| description | Abstract Background Although highly heterogeneous among countries, the incidence rates of low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA) have been increasing globally over the past two decades. To better understand the cause of these secular trends, this study aimed to investigate the effects of age, period, and birth cohort on LBW, PTB, and SGA rates in Shanghai. Methods Data from 2,958,695 singleton live births at 24–41 gestational weeks between 2004 and 2020 were obtained for this study. Age-period-cohort models based on Poisson regression were used to evaluate the independent effects of maternal age, delivery period, and maternal birth cohort on the trends in LBW, PTB, and SGA. Results The overall prevalence rates of LBW, PTB, and SGA were 2.9%, 4.7%, and 9.3%, respectively, and significant changes were observed (average annual change: + 10.7‰, + 9.1‰, -11.9‰) from 2004 to 2020. Cohort effect increased steadily, from 1960 (risk ratio [RR] = 0.71, 95% confidence interval [CI]: 0.65–0.78) to 1993 (RR = 0.97, 95% CI: 0.94–1.01) for LBW and from 1960 (RR = 0.69, 95% CI: 0.64–0.75) to 2004 (RR = 1.02, 95% CI: 0.94–1.12) for PTB. A strong cohort effect was found with the highest risk of SGA (RR = 1.82, 95% CI: 1.72–1.93) in 1960 and the lowest risk (RR = 0.57, 95% CI: 0.54–0.61) in 2004, compared with the reference cohort of 1985. There was a “U-shaped” maternal age effect on LBW and PTB and a weak period effect on the three birth outcomes. Conclusions Our findings suggested a significant independent effect of age, period, and birth cohort on the three birth outcomes. The increasing rates of LBW and PTB motivated us to focus on young and advanced pregnant women. Meanwhile, the prevalence of SGA decreased steadily, illustrating the need for further research on the mechanisms underlying these trends. |
| first_indexed | 2024-03-12T21:05:53Z |
| format | Article |
| id | doaj.art-445f281833124483bf15e68f8706b3e0 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-03-12T21:05:53Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-445f281833124483bf15e68f8706b3e02023-07-30T11:26:45ZengBMCBMC Pregnancy and Childbirth1471-23932023-07-0123111310.1186/s12884-023-05799-9Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysisRongfei Zhou0Huiting Yu1Naisi Qian2Shan Jin3Renzhi Cai4Lei Chen5Chunfang Wang6Fan Wu7School of Public Health, Fudan UniversitySchool of Public Health, Fudan UniversityVital Statistical Department, Shanghai Municipal Center for Disease Control and Prevention, Institute of Health InformationVital Statistical Department, Shanghai Municipal Center for Disease Control and Prevention, Institute of Health InformationVital Statistical Department, Shanghai Municipal Center for Disease Control and Prevention, Institute of Health InformationVital Statistical Department, Shanghai Municipal Center for Disease Control and Prevention, Institute of Health InformationVital Statistical Department, Shanghai Municipal Center for Disease Control and Prevention, Institute of Health InformationSchool of Public Health, Fudan UniversityAbstract Background Although highly heterogeneous among countries, the incidence rates of low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA) have been increasing globally over the past two decades. To better understand the cause of these secular trends, this study aimed to investigate the effects of age, period, and birth cohort on LBW, PTB, and SGA rates in Shanghai. Methods Data from 2,958,695 singleton live births at 24–41 gestational weeks between 2004 and 2020 were obtained for this study. Age-period-cohort models based on Poisson regression were used to evaluate the independent effects of maternal age, delivery period, and maternal birth cohort on the trends in LBW, PTB, and SGA. Results The overall prevalence rates of LBW, PTB, and SGA were 2.9%, 4.7%, and 9.3%, respectively, and significant changes were observed (average annual change: + 10.7‰, + 9.1‰, -11.9‰) from 2004 to 2020. Cohort effect increased steadily, from 1960 (risk ratio [RR] = 0.71, 95% confidence interval [CI]: 0.65–0.78) to 1993 (RR = 0.97, 95% CI: 0.94–1.01) for LBW and from 1960 (RR = 0.69, 95% CI: 0.64–0.75) to 2004 (RR = 1.02, 95% CI: 0.94–1.12) for PTB. A strong cohort effect was found with the highest risk of SGA (RR = 1.82, 95% CI: 1.72–1.93) in 1960 and the lowest risk (RR = 0.57, 95% CI: 0.54–0.61) in 2004, compared with the reference cohort of 1985. There was a “U-shaped” maternal age effect on LBW and PTB and a weak period effect on the three birth outcomes. Conclusions Our findings suggested a significant independent effect of age, period, and birth cohort on the three birth outcomes. The increasing rates of LBW and PTB motivated us to focus on young and advanced pregnant women. Meanwhile, the prevalence of SGA decreased steadily, illustrating the need for further research on the mechanisms underlying these trends.https://doi.org/10.1186/s12884-023-05799-9EpidemiologyPreterm birthSmall for gestational ageAge-period-cohort analysis |
| spellingShingle | Rongfei Zhou Huiting Yu Naisi Qian Shan Jin Renzhi Cai Lei Chen Chunfang Wang Fan Wu Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis BMC Pregnancy and Childbirth Epidemiology Preterm birth Small for gestational age Age-period-cohort analysis |
| title | Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis |
| title_full | Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis |
| title_fullStr | Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis |
| title_full_unstemmed | Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis |
| title_short | Secular trends of low birth weight, preterm birth, and small for gestational age in Shanghai from 2004 to 2020: an age-period-cohort analysis |
| title_sort | secular trends of low birth weight preterm birth and small for gestational age in shanghai from 2004 to 2020 an age period cohort analysis |
| topic | Epidemiology Preterm birth Small for gestational age Age-period-cohort analysis |
| url | https://doi.org/10.1186/s12884-023-05799-9 |
| work_keys_str_mv | AT rongfeizhou seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis AT huitingyu seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis AT naisiqian seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis AT shanjin seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis AT renzhicai seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis AT leichen seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis AT chunfangwang seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis AT fanwu seculartrendsoflowbirthweightpretermbirthandsmallforgestationalageinshanghaifrom2004to2020anageperiodcohortanalysis |