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Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts
Abstract
Background: A healthy start to life is a major priority in efforts to reduce health inequalities across Europe, with important implications for the health of future generations. There is limited combined evidence on inequalities in health among newborns across a range of European countries. Methods: Prospective cohort data of 75 296 newborns from 12 European countries were used. Maternal education, preterm and small for gestational age births were determined at baseline along with covariate data. Regression models were estimated within each cohort and meta-analyses were conducted to compare and measure heterogeneity between cohorts. Results: Mother's education was linked to an appreciable risk of preterm and small for gestational age (SGA) births across 12 European countries. The excess risk of preterm births associated with low maternal education was 1.48 (1.29 to 1.69) and 1.84 (0.99 to 2.69) in relative and absolute terms (Relative/Slope Index of Inequality, RII/SII) for all cohorts combined. Similar effects were found for SGA births, but absolute inequalities were greater, with an SII score of 3.64 (1.74 to 5.54). Inequalities at birth were strong in the Netherlands, the UK, Sweden and Spain and marginal in other countries studied. Conclusions: This study highlights the value of comparative cohort analysis to better understand the relationship between maternal education and markers of fetal growth in different settings across Europe.
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“Inequalities on the basis of various individual and area level measures of maternal socioeconomic status (SES) are consistently demonstrated [2], with estimates from Europe indicating an almost 50% higher prevalence among the least compared with most educated mothers [3, 4]”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [3]
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Cited by
The global epidemiology of preterm birth
Vogel, J. P., Chawanpaiboon, S., Moller, A.-B., Watananirun, K., Bonet, M., & Lumbiganon, P. (2018) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2018.04.003 · Cited by 1,005
Beck, A. F., Edwards, E. M., Horbar, J. D., Howell, E. A., McCormick, M. C., & Pursley, D. M. (2020) · Pediatric Research · doi:10.1038/s41390-019-0513-6 · Cited by 224
Épidémiologie et facteurs de risque de la prématurité
Torchin, H., & Ancel, P.-Y. (2016) · Journal de Gynécologie Obstétrique et Biologie de la Reproduction · doi:10.1016/j.jgyn.2016.09.013 · Cited by 134
Mediators of socioeconomic inequalities in preterm birth: a systematic review
McHale, P., Maudsley, G., Pennington, A., Schlüter, D. K., Barr, B., Paranjothy, S., & Taylor-Robinson, D. (2022) · BMC Public Health · doi:10.1186/s12889-022-13438-9 · Cited by 89
Heikkilä, K., Pulakka, A., Metsälä, J., Alenius, S., Hovi, P., Gissler, M., Sandin, S., & Kajantie, E. (2021) · PLOS ONE · doi:10.1371/journal.pone.0261952 · Cited by 33
Metadata
- Authors
- Ruiz, M., Goldblatt, P., Morrison, J., Kukla, L., Švancara, J., Riitta-Järvelin, M., Taanila, A., Saurel-Cubizolles, M.-J., Lioret, S., Bakoula, C., Veltsista, A., Porta, D., Forastiere, F., van Eijsden, M., Vrijkotte, T. G. M., Eggesbø, M., White, R. A., Barros, H., Correia, S., Vrijheid, M., Torrent, M., Rebagliato, M., Larrañaga, I., Ludvigsson, J., Olsen Faresjö, Å., Hryhorczuk, D., Antipkin, Y., Marmot, M., & Pikhart, H.
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 2015-04-24
- Volume
- 69
- Issue
- 9
- Pages
- 826-833
- ISSN
- 0143-005X
- 1470-2738
- Cited by
- 188
- References
- 4
- Language
- en
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