Delivery at Term: Impact of University Education by Week of Gestation

Auger, Nathalie; Leduc, Line; Naimi, Ashley I.; Fraser, William D.

doi:10.1016/j.jogc.2015.11.001

Cited by 12 publications

(10 citation statements)

References 32 publications

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“…A higher level of education is associated with a longer pregnancy (26,27) which is also confirmed by our results, but with no statistical significance. Roma females gestational age was 38.7 weeks and non-Roma females had gestational age 38.8 weeks with no statistical significance.…”

Section: Discussionsupporting

confidence: 80%

Risk factors of preterm birth and low birth weight neonates among Roma and non-Roma mothers

Jana

Rimárová

Urdzík

et al. 2018

Cent Eur J Public Health

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Objective: This study analyses the differences in birth outcomes between Roma and non-Roma mothers and investigates the potential causes of such differences.Methods: We conducted a retrospective cohort study of 1,989 non-Roma and 799 Roma mothers who gave birth in 2014 and 2015 at the Gynaecology and Obstetrics Clinic of Louis Pasteur University Hospital in Košice. Data on mothers and new-born infants have been obtained from the birth book and from the reports on mothers at childbirth. For low birth weight we considered the weight of a new-born weighing less than 2,500 grams and as for premature birth we referred to childbirth before pregnancy week 37. The file was split by ethnicity and statistically processed in IBM SPSS Statistics 21.0.Results: Our results confirmed a lower birth weight among Roma children (-365.4 grams, p < 0.001). The shorter gestation age and higher risk of premature birth were not statistically significant regarding Roma children. Based on the characteristics of Roma mothers, they are at higher risk of giving birth as minor (OR = 23.64; 95% CI = 15.29-36.54; p < 0.001), as single mothers (OR = 7.13; 95% CI = 5.80-8.76; p < 0.001), with basic education or lack of education (OR = 141.31; 95% CI = 100. 47-198.76; p < 0.001). They also have a higher risk of smoking during pregnancy (OR = 23.84; 95% CI = 18.06-31.49; p < 0.001); drinking alcohol (OR = 11.71; 95% CI = 3.36-40.90; p < 0.001) and taking drugs (OR = 8.70; 95% CI = 1.81-42.02; p < 0.001). Roma women attended gynaecologists more rarely.Conclusion: It is therefore important to support the work of community health workers and stimulate collaboration between community health professionals, paediatricians and gynaecologists to overcome institutional barriers in maternity and child care for mothers living in Roma settlement.

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Section: Discussionsupporting

confidence: 80%

Risk factors of preterm birth and low birth weight neonates among Roma and non-Roma mothers

Jana

Rimárová

Urdzík

et al. 2018

Cent Eur J Public Health

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“…Maternal educational level is a well-documented risk factor for preterm birth risk and recent findings from Canada have shown an association with early-term birth. 34–36 Exposures related to mothers’ general quality of life and well-being (ie, living and employment conditions, air pollution, exposure to stress) could mediate the association with social status via physiological pathways. 37–41 In France, Prunet et al showed that social status was associated with preterm birth risk independently of use of medical care during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Are risk factors for preterm and early-term live singleton birth the same? A population-based study in France

et al. 2018

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ObjectivesTo investigate whether risk factors for preterm (<37 weeks gestation) and early-term birth (37 and 38 weeks gestation) are similar.DesignNationally representative cross-sectional study of births.SettingFrance in 2010.ParticipantsLive singleton births (n=14 326).Primary and secondary outcome measuresPreterm and early-term birth rates overall and by mode of delivery (spontaneous and indicated). Risk factors were maternal sociodemographic characteristics, previous preterm birth, height, prepregnancy body mass index (BMI) and smoking, assessed using multinomial regression models with full-term births 39 weeks and over as the reference group.ResultsThere were 5.5% preterm and 22.5% early-term births. Common risk factors were: a previous preterm delivery (adjusted relative risk ratio (aRRR) 8.2 (95% CI 6.2 to 10.7) and aRRR 2.4 (95% CI 2.0 to 3.0), respectively), short stature, underweight (overall and in spontaneous deliveries), obesity (in indicated deliveries only), a low educational level and Sub-Saharan African origin. In contrast, primiparity was a risk factor only for preterm birth, aRRR 1.8 (95% CI 1.5 to 2.2), while higher parity was associated with greater risk of early-term birth.ConclusionsMost population-level risk factors were common to both preterm and early-term birth with the exception of primiparity, and BMI which differed by mode of onset of delivery. Our results suggest that preterm and early-term birth share similar aetiologies and thus potentially common strategies for prevention.

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“…These patients may be poorer and have other comorbidities, both of which have been identified as independent risk factors for preterm birth. These patients may also be less involved in decision making and planning during pregnancy, and a previous study suggested that a greater proportion of these women believed that delivery at 34 gestational weeks was safe [ 15 , 16 ]. A population study including more than 500,000 singleton pregnancies in the UK reported Afro-Caribbean patients to be at 1.6 times greater odds of PTD before 37 gestational weeks than Caucasian patients [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Human Development Index (HDI) of the maternal country of origin as a predictor of perinatal outcomes - a longitudinal study conducted in Spain

Larroca

Arévalo-Serrano

Vila

et al. 2017

BMC Pregnancy Childbirth

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BackgroundIn an era of worldwide population displacement, recent studies have identified strong associations between social situations and perinatal outcomes among immigrants. Little is known about the effect of maternal social background on pregnancy outcomes. The Human Development Index (HDI) assesses the following dimensions of human development: life expectancy, education level and income. The objective of our study was to determine if maternal HDI may be used to identify women at increased odds of poor pregnancy outcomes.MethodsWe conducted a longitudinal population-based study in a tertiary centre in Madrid, Spain. The outcome variables were maternal and perinatal/antenatal mortality, preeclampsia (PE), low birth weight (LBW), gestational diabetes mellitus (GDM), preterm delivery (PTD) before 37 and 34 gestational weeks, abnormal cardiotocography (CTG) during delivery, C-section (CS) due to abnormal CTG, pH < 7.10 at birth, Apgar at 5 min ≤ 7, and resuscitation type ≥3. We performed multivariate logistic regression analyses adjusted for potential confounding variables to evaluate the associations between maternal HDI and perinatal outcomes.ResultsIn total, 38,719 singleton infants who were born in our maternity ward between 2010 and 2016 and had perinatal outcome data available were included in this study. The neonates of women from medium/low HDI countries had significantly lower odds of low birth weight (LBW) than their very high HDI country counterparts (OR 0.63, 95% CI 0.55–0.72). However, the odds of PTD before 37 gestational weeks and PE were higher in the medium/low HDI group than the very high HDI group (OR 1.26, 95% CI 1.04–1.53; OR 1.35, 95% CI 1.02–1.79, respectively). Poorer neonatal outcomes were identified in the medium/low HDI group than the very high HDI group, including greater odds of abnormal CTG, CS due to abnormal CTG and Apgar 2 ≤ 7 (p < 0.05).ConclusionsOur findings suggest that the infants of mothers from medium/low HDI had lower odds of LBW but higher odds of PTD, PE and poor neonatal outcomes. These results support the hypothesis that maternal HDI can be used to understand the impact of maternal origin on pregnancy outcomes. Further studies are needed to confirm its validity.

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Delivery at Term: Impact of University Education by Week of Gestation

Cited by 12 publications

References 32 publications

Risk factors of preterm birth and low birth weight neonates among Roma and non-Roma mothers

Risk factors of preterm birth and low birth weight neonates among Roma and non-Roma mothers

Are risk factors for preterm and early-term live singleton birth the same? A population-based study in France

Human Development Index (HDI) of the maternal country of origin as a predictor of perinatal outcomes - a longitudinal study conducted in Spain

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