Investigating the Relationship Between Structural Determinants of Health and Preterm Delivery: A Systematic Review

Abstract

Background: Preterm delivery is one of the main causes of newborn mortality, signifying the inequality of conditions in receiving the necessary prenatal care. Objectives: The present systematic review was conducted to investigate the relationship between preterm delivery and socio-structural determinants of health with an emphasis on occupation, education, and income in Iranian society based on the World Health Organization model. Methods: In this systematic review, all observational articles published from 2000 to November 2021 were examined by searching the international and Persian databases of Scopus, PubMed, Google Scholar, Web of Science, Embase, ProQuest, Cochrane, IranDoc, and SID. Keywords were extracted through the MESH. The articles were searched using English and Persian keywords of occupation, education, income, social and economic status, and preterm delivery and appropriate operators, such as AND, OR, as well as a combination of the search strategy of each database, and all related articles were collected. Results: In the initial search, 1456 articles were found, and a total number of 17 articles were finally included in the study, of which 12 articles were on occupation, ten articles on education, four studies on income, two studies on socio-economic status, seven studies on occupation, and eight studies on education. All studies on income and socio-economic status had shown a statistically significant relationship between these structural determinants and preterm delivery. Conclusions: Preterm delivery is a prevalent problem with critical complications in Iran and there is a significant relationship between structural determinants and preterm delivery. Appropriate interventions, such as life skills training, self-care, and prenatal care can help mitigate pregnancy outcomes.