Magnitude of income-related disparities in adverse perinatal outcomes

Abstract

BackgroundTo assess and compare multiple measurements of socioeconomic position (SEP) in order to determine the relationship with adverse perinatal outcomes across various contexts.MethodsA birth registry, the Nova Scotia Atlee Perinatal Database, was confidentially linked to income tax and related information for the year in which delivery occurred. Multiple logistic regression was used to examine odds ratios between multiple indicators of SEP and multiple adverse perinatal outcomes in 117734 singleton births between 1988 and 2003. Models for after tax family income were also adjusted for neighborhood deprivation to gauge the relative magnitude of effects related to SEP at both levels. Effects of SEP were stratified by single- versus multiple-parent family composition, and by urban versus rural location of residence.ResultsThe risk of small for gestational age and spontaneous preterm birth was higher across all the indicators of lower SEP, while risk for large for gestational age was lower across indicators of lower SEP. Higher risk of postneonatal death was demonstrated for several measures of lower SEP. Higher material deprivation in the neighborhood of residence was associated with increased risk for perinatal death, small for gestational age birth, and iatrogenic and spontaneous preterm birth. Family composition and urbanicity were shown to modify the association between income and some perinatal outcomes.ConclusionsThis study highlights the importance of understanding the definitions of SEP and the mechanisms that lead to the association between income and poor perinatal outcomes, and broadening the types of SEP measures used in some cases.

Safety of insulin analogs during pregnancy: a meta-analysis

“…Little information about those factors was available for the participants in our analysis. Shankardassk et al [37] demonstrated that adverse perinatal outcomes are related to lower socioeconomic position, and the fact that the economics of a society affect pregnancy outcomes is widespread [38]. In addition, parental education and income influence pregnancy outcomes [39].…”

“…In addition, parental education and income influence pregnancy outcomes [39]. Household income is weakly related to the risk of preterm birth [37]. Other factors, such as weight gain during pregnancy, affect pregnancy complications, and Sciffres et al [40] reported that excess maternal weight leads to a higher incidence of LGA in obese and overweight women with diabetes compared to normal-weight pregnant women with diabetes.…”

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