RESUMEN
OBJECTIVE: to analyse the relationship between socioeconomic factors and the prevalence at birth of a selected group of congenital malformations (CM): neural tube defects (NTD), orofacial clefts (OFC), Down syndrome (DS). DESIGN: matched case-control study. The aim of the study was to compare the parental socioeconomic status of 485 children affected by one of the selected congenital malformations with an appropriate control group, using both a synthetic index, as well as comparing each socioeconomic characteristic. Socioeconomic measures included maternal and paternal education and employment. SETTING: Delivery certificate database from 18 Italian regions, years 2002-2003. MAIN OUTCOME MEASURES: odds ratio (OR) measuring the association between the presence at birth of specific CMs and socioeconomic factors, estimated through logistic regression models. RESULTS: the study showed a higher risk for NTD (OR 2.73; 95% CI 1.36-5.50) and OFC (OR 1.18; 95% CI 1.05-1.33)for parents in a low social class. As well, the estimated risk of DS is slightly higher, though not statistically significant (OR 1.08; 95% CI 0.98-1.19). Among the socioeconomic variables taken into consideration, the mother's education level represented a significant risk factor associated with OFC occurrence. CONCLUSION: the results suggested that the socioeconomic level may represent a selective risk factor for specific CMs, confirming the role that social inequalities have on health, in particular on reproductive health. Such evidences should be considered when programming specific actions aimed at preventing congenital malformations.