Early childhood health in Bielefeld, Germany (BaBi study): study protocol of a social-epidemiological birth cohort

Spallek, Jacob; Grosser, Angelique; Höller-Holtrichter, Chantal; Doyle, Ina-Merle; Breckenkamp, Jürgen; Razum, Oliver

doi:10.1136/bmjopen-2017-018398

Cited by 19 publications

(25 citation statements)

References 12 publications

(6 reference statements)

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“…This analysis is based on data collected in the BaBi (Babys in Bielefeld) birth cohort study [16]. Over a three-year period (2013-16), we recruited 977 women and conducted standardized computer-assisted personal interviews (CAPI) during pregnancy (n = 305) or shortly after birth (n = 672).…”

Section: Methodsmentioning

confidence: 99%

“…A limitation of our analyses is that the BaBi study sample is skewed toward more educated and wealthier women. This is partly due to the recruitment strategy which started with a passive recruitment phase during which flyers and response boxes were left in gynecologists and midwifes practices [16]. Such recruitment is more likely to attract better-educated participants than active recruitment where women are directly approached by the interviewers.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…In the BaBi birth cohort study set in Bielefeld, Germany, a third of the participating women have a migration background and data is available on educational attainment and income level [16]. This allows investigating whether and how a measure of migration background (namely migration status) and two markers of socioeconomic position (education and income) affect the risk of an emergency caesarean section and whether they interact with each other.…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study

Miani

Ludwig

Breckenkamp

et al. 2020

BMC Pregnancy Childbirth

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Background: Women with a migration background are reportedly at a higher risk of emergency caesarean section. There is evidence that this is due in part to suboptimal antenatal care use and quality of care. Despite the fact that migrant women and descendants of migrants are often at risk of socioeconomic disadvantage, there is, in comparison, scarce and incomplete evidence on the role of socioeconomic position as an independent risk factor for emergency caesarean delivery. We therefore investigate whether and how migration background and two markers of socioeconomic position affect the risk of an emergency caesarean section and whether they interact with each other. Methods: In 2013-2016, we recruited women during the perinatal period in Bielefeld, Germany, collecting data on health and socioeconomic and migration background, as well as routine perinatal data. We studied associations between migration background (1st generation migrant, 2nd/3rd generation woman, no migration background), socioeconomic status (educational attainment and net monthly household income), and the outcome emergency caesarean section. Results: Of the 881 participants, 21% (n = 185) had an emergency caesarean section. Analyses showed no association between having an emergency caesarean section and migration status or education. Women in the lowest (< 800€/month) and second lowest (between 800 and 1750€/month) income categories were more likely (aOR: 1.96, CI: 1. and aOR: 2.36, respectively) to undergo an emergency caesarean section than women in the higher income groups. Conclusions: Migration status and education did not explain heterogeneity in mode of birth. Having a low household income, however, increased the chances of emergency caesarean section and thereby contributed towards producing health disadvantages. Awareness of these findings and measures to correct these inequalities could help to improve the quality of obstetric care.

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Section: Methodsmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study

Miani

Ludwig

Breckenkamp

et al. 2020

BMC Pregnancy Childbirth

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“…Baseline data included modules on pregnancy-related health, health care and behaviours and on socioeconomic and migration backgrounds. More details about the aims and designs of those studies can be found elsewhere (Brenne et al 2015;Spallek et al 2017). The participants were introduced to the study by researchers in one-to-one conversations during which were answered any questions they may have had.…”

Section: Methodsmentioning

confidence: 99%

“…They, however, did not perform further analyses aiming to identify factors explaining this difference. Building on this work, there is currently an opportunity to explore further those issues within the German context by analysing the combined baseline data of two German cohort studies: the aforementioned Berlin perinatal study (Brenne et al 2015) and the BaBi birth cohort study based in Bielefeld (Spallek et al 2017). While both studies are comparable in their designs and intent, they were conducted in environments with different socioeconomic characteristics and have rather different participants' profiles.…”

Section: Introductionmentioning

confidence: 99%

Are Social Status and Migration Background Associated with Utilization of Non-medical Antenatal Care? Analyses from Two German Studies

Ludwig

Miani

Breckenkamp

et al. 2020

Matern Child Health J

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Objective Non-medical antenatal care (ANC) refers to a range of non-medical services available to women during pregnancy aiming at supporting women and prepare them for the birth and the postpartum period. In Germany, they include antenatal classes, breastfeeding classes and pregnancy-specific yoga or gymnastics courses. Studies suggest that various types of nonmedical ANC carry benefits for both the women and their babies. Little is known about the uptake of non-medical ANC among different socioeconomic population subgroups, but one may expect lower utilization among socio-economically disadvantaged women. We analyzed factors contributing to the utilization of non-medical ANC in general and antenatal classes in particular. Methods Baseline data of the Bielefeld BaBi birth cohort (2013-2016) and the Berlin perinatal study (2011)(2012) were analyzed. Comparing the two cohorts allowed to increase the socio-economic and migration background variance of the study population and to capture the effect of the local context on uptake of services. Multivariate logistic regression analyses were performed to study associations between the uptake of non-medical ANC and socio-economic and migration status. Results In Berlin and Bielefeld, being a first generation migrant and having lower levels of education were associated with lower non-medical ANC uptake. In Berlin, being a 2nd generation woman or having a low income was also associated with lower uptake. Conclusions for PracticeOur study suggests that non-medical ANC remains in some part the prerogative of non-migrant, well-educated and economically privileged women. Since differences in non-medical ANC have the potential to create inequalities in terms of birth outcomes and maternal health during pregnancy and post-partum, more efforts are needed to promote the use of non-medical ANC by all population groups. SignificanceWhat is already known on this subject? Non-medical antenatal care (ANC) contributes to an enhanced pregnancy experience and improved birth outcomes. A recent study showed a lower uptake of non-medical antenatal care among migrants than among women without migration background using unadjusted data. Socioeconomic status has been hypothesized to impact the utilization of non-medical ANC.What this study adds? This study highlights the existence of social inequalities in non-medical ANC use. Our results suggest that there is a strong relationship between the use of non-medical ANC and migration background and educational attainment, with 1st generation migrants and women with low and medium levels of education having a lower uptake of services.

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Active and Passive Exposure to Tobacco and e-Cigarettes During Pregnancy

Schilling

Spallek

Maul

et al. 2020

Matern Child Health J

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Objectives Active and passive exposure to tobacco cigarettes during pregnancy is associated with multiple negative health outcomes for the fetus. In addition, exposure to e-cigarettes has been progressively discussed as a new threat to fetal health. Until now, there has been a lack of studies examining active and passive exposure to tobacco and e-cigarettes among pregnant women. The objective of our current STudy on E-cigarettes and Pregnancy (STEP) was to advance and complement the current knowledge regarding active and passive exposure to tobacco and e-cigarettes before pregnancy and during early and late pregnancy. Methods One element of the STEP study was a quantitative cross-sectional design: A sample of 540 pregnant women recruited at an obstetrician clinic in Hamburg from April 2018 to January 2019 were surveyed once via a standardized questionnaire and provided complete information regarding their consumption of tobacco and e-cigarettes. We performed a descriptive analysis of tobacco and e-cigarette use before pregnancy and during early and late pregnancy, as well as bivariate analysis of these variables with sociodemographic determinants. Passive exposure was assessed by asking the participating pregnant women about the consumption of tobacco and e-cigarettes by their partners, in general, and in their homes. Results Before pregnancy, 20.0% of the participants used tobacco cigarettes exclusively, 1.3% used e-cigarettes exclusively, and 6.5% were dual users. Educational level was significantly associated with tobacco cigarette use (p < 0.001) and dual use (p = 0.047) before pregnancy. During early (late) pregnancy, 8.7% (2.8%) used tobacco cigarettes and 0.4% (0.0%) used e-cigarettes exclusively. Twenty-point nine percent of women’s partners consumed tobacco cigarettes exclusively, 2.7% consumed e-cigarettes exclusively, and 2.7% consumed both. A total of 8.5% (16.7%) of the partners who consumed tobacco cigarettes exclusively (e-cigarettes exclusively) did so in the women’s homes. Conclusions for Practice Among pregnant women, the use of tobacco cigarettes remains prominent before and during pregnancy, while e-cigarette use predominately occurs before pregnancy. Our study shows that pregnant women are frequently exposed to their partners’ tobacco and e-cigarette use within their homes. Strategies to reduce such exposure should be further intensified.

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Early childhood health in Bielefeld, Germany (BaBi study): study protocol of a social-epidemiological birth cohort

Cited by 19 publications

References 12 publications

Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study

Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study

Are Social Status and Migration Background Associated with Utilization of Non-medical Antenatal Care? Analyses from Two German Studies

Active and Passive Exposure to Tobacco and e-Cigarettes During Pregnancy

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