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As China continues on its path of economic and social reform, it may pay the price in premature babies.

Winthrop Professor John Newnham, Head of the School of Women's and Infants' Health, and colleagues have recently published a paper comparing the rates of preterm births among women in rural and urban China with those of Chinese-born women in Hong Kong and Western Australia.

The increase in rates points to an increasingly Western style of life.

Professor Newnham, who is also the honorary director of the Department of Obstetrics and Gynaecology, Nanjing University, hopes that further research based on this first research project with colleagues at Nanjing may help to prevent a possible rise in preterm births as China becomes more Westernised.

Preterm births can often lead to health problems later in life, as well as costing the community millions of dollars each year, keeping premature babies alive.

The paper, published in the Australian and New Zealand Journal of Obstetrics and Gynaecology, stops short of stipulating that Western lifestyle factors are the sole contributing factor, but rather suggests that they may be involved in at least some of the causal pathways.

"While there is a lot of research being done in Australia on the causes and prevention of preterm births, the potential effects of differing environments on pregnant women are poorly understood in China," Professor Newnham said.

The rates of preterm births were taken from records of more than 250,000 births in mainland China, Hong Kong and Western Australia.

The study found that preterm birth rates in urban and rural Jiangsu Province were 2.6 per cent and 2.9 per cent respectively, 2.5 per cent among China-born women in Western Australia who needed an interpreter (in other words, a woman who had presumably not assimilated to the Western lifestyle) and 4.9 per cent for those who did not require an interpretor.

These compared to a rate of 7.6 per cent among Chinese women in Hong Kong and 7.8 per cent among women in Western Australia who described themselves as Caucasians.

Professor Newnham found that while only 0.1 per cent of pregnant women in Jiangsu Province smoked, 17.5 per cent of pregnant women overall in WA smoked.

"Increasing rates of preterm births, as women are exposed to Western lifestyles may also result from sexual practices," he said. "Among Chinese women, sexual activity appears to be infrequent." Sexual activity among pregnant Chinese women in Hong Kong was reduced by more than 90 per cent, while it was reported to continue during pregnancy in 86 - 100 per cent of couples in non-Chinese populations.

"Any role for sexual activity in causing preterm birth remains controversial and unproven, but it most certainly presents an area warranting further investigation," he said.

Professor Newnham said the possibility of genetic characteristics influencing preterm births also existed. "It is well-established that preterm birth is more likely if close relatives have also delivered at early gestational ages.

"Further research is required to determine differences in the causal pathways leading to preterm birth in Chinese and other racial groups."

Published in UWA News , 8 August 2011