Is the economic crisis affecting birth outcome in Spain? Evaluation of temporal trend in underweight at birth (2003-2012).

ABSTRACT

BACKGROUND: There is growing evidence of the impact of the current European economic crisis on health. In Spain, since 2008, there have been increasing levels of impoverishment and inequality, and important cuts in social services. AIM: The objective is to evaluate the impact of the economic crisis on underweight at birth in Spain. METHOD: Trends in underweight at birth were examined between 2003 and 2012. Underweight at birth is defined as a singleton, term neonatal weight lesser than -2 SD from the median weight at birth for each sex estimated by the WHO Standard Growth Reference. Using data from the Statistical Bulletin of Childbirth, 2 933 485 live births born to Spanish mothers have been analysed. Descriptive analysis, seasonal decomposition analysis and crude and adjusted logistic regression including individual maternal and foetal variables as well as exogenous economic indicators have been performed. RESULTS AND CONCLUSIONS: Results demonstrate a significant increase in the prevalence of underweight at birth from 2008. All maternal-foetal categories were affected, including those showing the lowest prevalence before the crisis. In the full adjusted logistic regression, year-on-year GDP per capita remains predictive on underweight at birth risk. Previous trends in maternal socio-demographic profiles and a direct impact of the crisis are discussed to explain the trends described.