Maternal Education as a Modifier of the Association between Low Birthweight and Infant Mortality

Shoham-Yakubovich, I; Barell, Vita

doi:10.1093/ije/17.2.370

Cited by 36 publications

(15 citation statements)

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“…It is well documented that birth weight increases and infant mortality declines with increased maternal education (Din-Dzietham and Hertz-Picciotto 1998; Gortmaker 1979; Kramer 1987; Singh and Yu 1995), although infant mortality has been reported to increase at very high levels of maternal education (e.g., more than 16 years of education) (Haglund et al 1993; Shoham-Yakubovich and Barel 1988). The results presented earlier are consistent with these general findings.…”

Section: Discussionmentioning

confidence: 99%

Maternal Education, Birth Weight, and Infant Mortality in the United States

et al. 2012

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This research determines whether the observed decline in infant mortality with socioeconomic level, operationalized as maternal education (dichotomized as college or more, versus high school or less), is due to its “indirect” effect (operating through birth weight) and/or to its “direct” effect (independent of birth weight). The data used are the 2001 U.S. national African American, Mexican American, and European American birth cohorts by sex. The analysis explores the birth outcomes of infants undergoing normal and compromised fetal development separately by using covariate density defined mixture of logistic regressions (CDDmlr). Among normal births, mean birth weight increases significantly (by 27–108 g) with higher maternal education. Mortality declines significantly (by a factor of 0.40–0.96) through the direct effect of education. The indirect effect of education among normal births is small but significant in three cohorts. Furthermore, the indirect effect of maternal education tends to increase mortality despite improved birth weight. Among compromised births, education has small and inconsistent effects on birth weight and infant mortality. Overall, our results are consistent with the view that the decrease in infant death by socioeconomic level is not mediated by improved birth weight. Interventions targeting birth weight may not result in lower infant mortality.

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Section: Discussionmentioning

confidence: 99%

Maternal Education, Birth Weight, and Infant Mortality in the United States

et al. 2012

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“…Maternal smoking habits refer to information collected at the first prenatal visit (around week [10][11][12] and stored in the Medical Birth Register.…”

Section: Maternal Risk Factors Studiedmentioning

confidence: 99%

“…Socio-economic factors are important risk factors for perinatal deaths, varying in strength between different populations (9)(10)(11)(12). Smoking is an important component of this phenomenon and is a well known risk factor for stillbirth and early neonatal death (2,4,(13)(14)(15) but also for later death (16), including sudden infant death (SIDS) (17)(18)(19).…”

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confidence: 99%

Maternal risk factors for cause-specific stillbirth and neonatal death

et al. 1999

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Background.To study specific effects of four maternal risk factors: age, parity, educational level, smoking, for specific causes of stillbirth and neonatal death according to a previously described hierarchic classification. Methods. The study is based on 9,785 stillbirths or neonatal deaths among infants born in Sweden, 1983Sweden, -1995 and identified with various Swedish health registers. Statistical analysis is performed using Mantel-Haenszel analysis. Results. Some risk factors, known from the literature, were confirmed and could be quantified. In addition, high parity was shown to increase the risk for death associated with multiple births (ORΩ2.49, 95% CI 2.07-3.01) and low educational level seems to be protective for such death (ORΩ0.75, 95% CI 0.60-0.93). If the infant is SGA, the risk for death is higher at high than at low parity (1.70, 95% CI 1.19-2.43, and 1.0, 95% CI 1.06-1.15, respectively). Maternal smoking seems to aggravate the placental abruption because the death risk in the presence of abruption increases when the mother smoked (ORΩ1.74, 95% CI 45-2.08).Conclusions. The study shows that the groups of the classification system used (NICE) differ in their association with known risk factors for stillbirth and neonatal deaths and an analysis based on specific causes of death can therefore unravel risk factors hidden when total mortality is used. The computerized method of classification and the cause-of-death classification developed by us is clearly useful for such analyses which requires large materials.

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“…However, the picture of a biological specificity of the birthweight was criticized by some studies in ethnically homogenous populations. Among others, Carlson and Hoem [3] found, in a study concerning the Czech Republic, that differences in birthweight distributions come from underlying differences in lifestyle and social conditions (see also [4,5,6]). Thus, to limit the impact of confounding factors, empirical analyses focus on birth outcomes of siblings.…”

Section: Introductionmentioning

confidence: 99%

Differences in Birthweight Outcomes: A Longitudinal Study Based on Siblings

Bacci

Bartolucci

Chiavarini

et al. 2014

IJERPH

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Objectives: We investigate the differences in birthweight between first- and second-borns, evaluating the impact of changes in pregnancy (e.g., gestational age), demographic (e.g., age), and social (e.g., education level, marital status) maternal characteristics. Data and Methods: All analyses are performed on data collected in Umbria (Italy) taking into account a set of 792 women who delivered twice from 2005 to 2008. Firstly, we use a univariate paired t-test for the comparison between weights of first- and second-borns; Secondly, we use linear and nonlinear regression approaches in order to: (i) evaluate the effect of demographic and social maternal characteristics and (ii) predict the odds-ratio of low and high birthweight infants, respectively. Results: We find that the birthweight of second-borns is significantly higher than that of first-borns. Statistically significant effects are related with a longer gestational age, an increased number of visits during the pregnancy, and the gender of infants. On the other hand, we do not observe any significant effect related with mother’s age and with other characteristics of interest.

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Maternal Education as a Modifier of the Association between Low Birthweight and Infant Mortality

Cited by 36 publications

References 0 publications

Maternal Education, Birth Weight, and Infant Mortality in the United States

Maternal Education, Birth Weight, and Infant Mortality in the United States

Maternal risk factors for cause-specific stillbirth and neonatal death

Differences in Birthweight Outcomes: A Longitudinal Study Based on Siblings

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