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Socioeconomic differences in the incidence of small-for-gestational-age birth and their time trend

Socioeconomic differences in the incidence of small-for-gestational-age birth and their time trend
Socioeconomic differences in the incidence of small-for-gestational-age birth and their time trend
Background: Children born small for gestational age (<10th percentile for birthweight at a particular gestational age; SGA) are at higher risk of morbidity and later disease risk. This study aims to quantify socioeconomic differences in SGA incidence and test whether these inequalities are shifting over time in an English population-based cohort.
Methods: We used 70,818 antenatal care and delivery records of singleton births to mothers aged ≥18 years at University Hospital Southampton, UK, utilising logistic regression modelling to investigate the risk of SGA by maternal educational qualification, employment, partner’s employment status and lone motherhood recorded at the first antenatal appointment. We also adjusted for maternal age, ethnicity, parity, blood pressure, gestational diabetes and baby’s sex. We tested mediation by maternal body mass index (BMI) category and smoking status. Interactions between social indicators and year estimate change in inequality over the study period (2004-2016).
Results: Mothers with no university degree were more likely to give birth to an SGA baby (adjusted odds ratio (aOR) 1.22, 99% CI 1.03, 1.45) than mothers with a degree. Maternal (aOR 1.26, CI 1.09, 1.45) and paternal unemployment (aOR 1.29, CI 1.03, 1.61) were also associated with higher SGA risk compared to employed mothers and partners respectively. There was no evidence of mediation by maternal smoking or BMI for those associations. However, despite lone motherhood being associated with higher risk of SGA (aOR 1.27, CI 1.01, 1.59), this was attenuated by adding maternal smoking status in the model (aOR 1.15, CI 0.92, 1.45). All of the linear trends in ORs by year showed no evidence of narrowing inequalities over time at the 1% statistical significance level.
Conclusion: Social inequalities in SGA incidence are evident, and have remained stable over the 12-year study period. Pre-conception and antenatal interventions targeting socially disadvantaged mothers are needed.
1101-1262
248
Wilding, Sam
a026cae1-cc72-49b5-a52b-ec1d931d72e1
Ziauddeen, Nida
3ad67dd8-26ba-498a-af0a-b1174298995b
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382
Wilding, Sam
a026cae1-cc72-49b5-a52b-ec1d931d72e1
Ziauddeen, Nida
3ad67dd8-26ba-498a-af0a-b1174298995b
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Alwan, Nisreen A.
0d37b320-f325-4ed3-ba51-0fe2866d5382

Wilding, Sam, Ziauddeen, Nida, Roderick, Paul and Alwan, Nisreen A. (2018) Socioeconomic differences in the incidence of small-for-gestational-age birth and their time trend. European Journal of Public Health, 28 (Suppl 4), 248. (doi:10.1093/eurpub/cky213.728).

Record type: Meeting abstract

Abstract

Background: Children born small for gestational age (<10th percentile for birthweight at a particular gestational age; SGA) are at higher risk of morbidity and later disease risk. This study aims to quantify socioeconomic differences in SGA incidence and test whether these inequalities are shifting over time in an English population-based cohort.
Methods: We used 70,818 antenatal care and delivery records of singleton births to mothers aged ≥18 years at University Hospital Southampton, UK, utilising logistic regression modelling to investigate the risk of SGA by maternal educational qualification, employment, partner’s employment status and lone motherhood recorded at the first antenatal appointment. We also adjusted for maternal age, ethnicity, parity, blood pressure, gestational diabetes and baby’s sex. We tested mediation by maternal body mass index (BMI) category and smoking status. Interactions between social indicators and year estimate change in inequality over the study period (2004-2016).
Results: Mothers with no university degree were more likely to give birth to an SGA baby (adjusted odds ratio (aOR) 1.22, 99% CI 1.03, 1.45) than mothers with a degree. Maternal (aOR 1.26, CI 1.09, 1.45) and paternal unemployment (aOR 1.29, CI 1.03, 1.61) were also associated with higher SGA risk compared to employed mothers and partners respectively. There was no evidence of mediation by maternal smoking or BMI for those associations. However, despite lone motherhood being associated with higher risk of SGA (aOR 1.27, CI 1.01, 1.59), this was attenuated by adding maternal smoking status in the model (aOR 1.15, CI 0.92, 1.45). All of the linear trends in ORs by year showed no evidence of narrowing inequalities over time at the 1% statistical significance level.
Conclusion: Social inequalities in SGA incidence are evident, and have remained stable over the 12-year study period. Pre-conception and antenatal interventions targeting socially disadvantaged mothers are needed.

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Accepted/In Press date: 5 June 2018
e-pub ahead of print date: 21 November 2018
Published date: November 2018
Venue - Dates: European Public Health Conference, Slovenia, 2018-11-28 - 2018-12-01

Identifiers

Local EPrints ID: 421945
URI: http://eprints.soton.ac.uk/id/eprint/421945
ISSN: 1101-1262
PURE UUID: f2d08983-1c44-4fff-8dfc-e1c3f34e01b9
ORCID for Sam Wilding: ORCID iD orcid.org/0000-0003-4184-2821
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Nisreen A. Alwan: ORCID iD orcid.org/0000-0002-4134-8463

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Date deposited: 11 Jul 2018 16:30
Last modified: 09 May 2020 00:40

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