Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort
Abstract Introduction Previous evidence examining the association between socioeconomic status and pregnancy complications are conflicted and often limited to using area‐based measures of socioeconomic status. In this study, we aimed to examine the association between individual‐level socioeconomic...
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14659 |
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| author | Gillian M. Maher Liam J. Ward Leah Hernandez Marius Kublickas Johannes J. Duvekot Fergus P. McCarthy Ali S. Khashan Karolina Kublickiene |
| author_facet | Gillian M. Maher Liam J. Ward Leah Hernandez Marius Kublickas Johannes J. Duvekot Fergus P. McCarthy Ali S. Khashan Karolina Kublickiene |
| author_sort | Gillian M. Maher |
| collection | DOAJ |
| description | Abstract Introduction Previous evidence examining the association between socioeconomic status and pregnancy complications are conflicted and often limited to using area‐based measures of socioeconomic status. In this study, we aimed to examine the association between individual‐level socioeconomic factors and a wide range of adverse pregnancy and neonatal outcomes using data from the IMPROvED birth cohort conducted in Sweden, the Netherlands and Republic of Ireland. Material and methods The study cohort consisted of women who participated in the IMPROvED birth cohort between 2013 and 2017. Data on socioeconomic factors were self‐reported and obtained at 15 weeks' gestation, and included level of education, employment status, relationship status, and income. Data on pregnancy and neonatal outcomes included gestational hypertension, pre‐eclampsia, gestational diabetes mellitus, emergency cesarean section, preterm birth, post term delivery, small for gestational age and Apgar score at 1 min. These data were obtained within 72 h following delivery and confirmed using medical records. Multivariable logistic regression examined the association between each socioeconomic variable and each outcome separately adjusting for maternal age, maternal body mass index, maternal smoking, maternal alcohol consumption and cohort center. We also examined the effect of exposure to any ≥2 risk factors compared to none. Results A total of 2879 participants were included. Adjusted results suggested that those with less than third level of education had an increased odds of gestational hypertension (OR: 1.74, 95% CI: 1.23–2.46), while those on a middle level of income had a reduced odds of emergency cesarean section (OR: 0.59, 95% CI: 0.42–0.84). No significant associations were observed between socioeconomic variables and neonatal outcomes. Exposure to any ≥2 socioeconomic risk factors was associated with an increased risk of preterm birth (OR: 1.75, 95% CI: 1.06–2.89). Conclusions We did not find strong evidence of associations between individual‐level socioeconomic factors and pregnancy and neonatal outcomes in high‐income settings overall, with only few significant associations observed among pregnancy outcomes. |
| format | Article |
| id | doaj-art-898b74acea9340a5ba5e8a3a28a1eaa7 |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-898b74acea9340a5ba5e8a3a28a1eaa72025-08-20T02:36:28ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122023-11-01102111459146810.1111/aogs.14659Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohortGillian M. Maher0Liam J. Ward1Leah Hernandez2Marius Kublickas3Johannes J. Duvekot4Fergus P. McCarthy5Ali S. Khashan6Karolina Kublickiene7INFANT Research Centre, University College Cork Cork IrelandDivision of Renal Medicine CLINTEC, Karolinska Institutet Stockholm SwedenDivision of Renal Medicine CLINTEC, Karolinska Institutet Stockholm SwedenDepartment of Fetal Medicine Karolinska University Hospital Stockholm SwedenDepartment of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC University Medical Center Rotterdam Rotterdam The NetherlandsINFANT Research Centre, University College Cork Cork IrelandINFANT Research Centre, University College Cork Cork IrelandDivision of Renal Medicine CLINTEC, Karolinska Institutet Stockholm SwedenAbstract Introduction Previous evidence examining the association between socioeconomic status and pregnancy complications are conflicted and often limited to using area‐based measures of socioeconomic status. In this study, we aimed to examine the association between individual‐level socioeconomic factors and a wide range of adverse pregnancy and neonatal outcomes using data from the IMPROvED birth cohort conducted in Sweden, the Netherlands and Republic of Ireland. Material and methods The study cohort consisted of women who participated in the IMPROvED birth cohort between 2013 and 2017. Data on socioeconomic factors were self‐reported and obtained at 15 weeks' gestation, and included level of education, employment status, relationship status, and income. Data on pregnancy and neonatal outcomes included gestational hypertension, pre‐eclampsia, gestational diabetes mellitus, emergency cesarean section, preterm birth, post term delivery, small for gestational age and Apgar score at 1 min. These data were obtained within 72 h following delivery and confirmed using medical records. Multivariable logistic regression examined the association between each socioeconomic variable and each outcome separately adjusting for maternal age, maternal body mass index, maternal smoking, maternal alcohol consumption and cohort center. We also examined the effect of exposure to any ≥2 risk factors compared to none. Results A total of 2879 participants were included. Adjusted results suggested that those with less than third level of education had an increased odds of gestational hypertension (OR: 1.74, 95% CI: 1.23–2.46), while those on a middle level of income had a reduced odds of emergency cesarean section (OR: 0.59, 95% CI: 0.42–0.84). No significant associations were observed between socioeconomic variables and neonatal outcomes. Exposure to any ≥2 socioeconomic risk factors was associated with an increased risk of preterm birth (OR: 1.75, 95% CI: 1.06–2.89). Conclusions We did not find strong evidence of associations between individual‐level socioeconomic factors and pregnancy and neonatal outcomes in high‐income settings overall, with only few significant associations observed among pregnancy outcomes.https://doi.org/10.1111/aogs.14659emergency cesarean sectiongestational hypertensionneonatal outcomespregnancy outcomespreterm birthsocioeconomic status |
| spellingShingle | Gillian M. Maher Liam J. Ward Leah Hernandez Marius Kublickas Johannes J. Duvekot Fergus P. McCarthy Ali S. Khashan Karolina Kublickiene Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort Acta Obstetricia et Gynecologica Scandinavica emergency cesarean section gestational hypertension neonatal outcomes pregnancy outcomes preterm birth socioeconomic status |
| title | Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort |
| title_full | Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort |
| title_fullStr | Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort |
| title_full_unstemmed | Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort |
| title_short | Association between socioeconomic status with pregnancy and neonatal outcomes: An international multicenter cohort |
| title_sort | association between socioeconomic status with pregnancy and neonatal outcomes an international multicenter cohort |
| topic | emergency cesarean section gestational hypertension neonatal outcomes pregnancy outcomes preterm birth socioeconomic status |
| url | https://doi.org/10.1111/aogs.14659 |
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