Socioeconomic and maternal determinants of small-for-gestational age births: patterns of increasing disparity.
Acta Obstet Gynecol Scand
; 88(5): 575-83, 2009.
Article
en En
| MEDLINE
| ID: mdl-19330564
ABSTRACT
OBJECTIVE:
To better characterize the relation between socioeconomic disadvantage and small-for-gestational age births (SGA).DESIGN:
Analysis of data from a mandatory population-based surveillance system.SETTING:
Public or private hospitals and at home. POPULATION All 877,951 singleton births occurring in New South Wales, Australia, between 1994 and 2004.METHODS:
Multilevel models were developed to determine the factors associated with babies weighing less than the 3rd percentile for gestation and gender. MAIN OUTCOMEMEASURES:
Odds of SGA.RESULTS:
The risk of SGA increased with increasing socioeconomic disadvantage. Smoking accounted for approximately 40% of the increased risk associated with socioeconomic disadvantage, and delayed antenatal care approximately 5%. While the absolute rate of SGA remained stable over the study period, the odds of SGA in mothers living in the most disadvantaged areas compared to those in the least disadvantaged areas increased from approximately 1.7 to 2.2. This trend persisted after accounting for maternal smoking. The risk of SGA over this period also increased in mothers commencing antenatal care after the first trimester. After accounting for smoking, socioeconomic disadvantage and clinical conditions, mothers under 21 years of age were at reduced risk of SGA, but mothers over 35 were at increased risk.CONCLUSIONS:
Socioeconomic disadvantage remains one of the dominant determinants of SGA, even in a developed country with universal insurance. This relation appears to be strengthening. Smoking patterns, inadequate antenatal care and clinical conditions partially account for this association and trend, however, most is mediated by other factors.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones del Embarazo
/
Atención Prenatal
/
Recién Nacido Pequeño para la Edad Gestacional
/
Fumar
/
Edad Materna
/
Retardo del Crecimiento Fetal
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Newborn
/
Pregnancy
País/Región como asunto:
Oceania
Idioma:
En
Revista:
Acta Obstet Gynecol Scand
Año:
2009
Tipo del documento:
Article
País de afiliación:
Estados Unidos