Temporal trends and factors associated with preterm birth: a time-series analysis of live births (2000–2021)
1
School of Medicine and Life Science, Pontificia Universidade Católica do Paraná, Curitiba, Brazil
2
Universidade Federal do Paraná, Curitiba, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A2324
ABSTRACT
BACKGROUND:
Maternal and child health is a central strategy for addressing health inequities 1. Preterm birth is globally recognized as the leading cause of mortality among children under five years of age 2. In Brazil, preterm birth is defined as delivery occurring before the 37th week of gestation 3. This study analyzed the temporal trend of preterm birth rates in the municipality of Curitiba, Paraná, Brazil, from 2000 to 2021, and evaluated their association with maternal characteristics, pregnancy-related factors, and Social Determinants of Health (SDH).
METHODS:
This quantitative, descriptive time-series study used data from the Live Birth Information System (SINASC). The following variables were analyzed: newborn sex; maternal age, education, and marital status; gestational age at birth; type of pregnancy (singleton or multiple); and prenatal care attendance. The analysis was conducted in two stages. First, Prais–Winsten regression was applied to assess temporal trends in preterm birth, considering calendar year as the independent variable. Second, Poisson regression models were used to examine the association between SDH and the occurrence of preterm birth.
RESULTS:
Over the study period, Curitiba presented an overall preterm birth rate of 7.8%, with a consistent increasing trend, rising from 5.9% in 2000 to 10.2% in 2021, corresponding to an Annual Percentage Change of 2.4%. Higher growth trends in preterm birth rates were observed among male newborns, adolescent mothers, mothers with low educational attainment, and mothers with a stable partner.
CONCLUSIONS:
A consistent increase in preterm birth was observed in Curitiba over the analyzed period, associated with specific maternal and social factors, highlighting the role of social determinants in the occurrence of this outcome. These findings underscore the need to strengthen maternal and child health policies, with an emphasis on preventive actions, improved quality of prenatal care, and the reduction of health inequities across the life course.
Maternal and child health is a central strategy for addressing health inequities 1. Preterm birth is globally recognized as the leading cause of mortality among children under five years of age 2. In Brazil, preterm birth is defined as delivery occurring before the 37th week of gestation 3. This study analyzed the temporal trend of preterm birth rates in the municipality of Curitiba, Paraná, Brazil, from 2000 to 2021, and evaluated their association with maternal characteristics, pregnancy-related factors, and Social Determinants of Health (SDH).
METHODS:
This quantitative, descriptive time-series study used data from the Live Birth Information System (SINASC). The following variables were analyzed: newborn sex; maternal age, education, and marital status; gestational age at birth; type of pregnancy (singleton or multiple); and prenatal care attendance. The analysis was conducted in two stages. First, Prais–Winsten regression was applied to assess temporal trends in preterm birth, considering calendar year as the independent variable. Second, Poisson regression models were used to examine the association between SDH and the occurrence of preterm birth.
RESULTS:
Over the study period, Curitiba presented an overall preterm birth rate of 7.8%, with a consistent increasing trend, rising from 5.9% in 2000 to 10.2% in 2021, corresponding to an Annual Percentage Change of 2.4%. Higher growth trends in preterm birth rates were observed among male newborns, adolescent mothers, mothers with low educational attainment, and mothers with a stable partner.
CONCLUSIONS:
A consistent increase in preterm birth was observed in Curitiba over the analyzed period, associated with specific maternal and social factors, highlighting the role of social determinants in the occurrence of this outcome. These findings underscore the need to strengthen maternal and child health policies, with an emphasis on preventive actions, improved quality of prenatal care, and the reduction of health inequities across the life course.
| eISSN: | 2654-1459 |
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