Cited by 382Maternal and Neonatal HealthcareHealth disparities and outcomesGlobal Maternal and Child Health

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Effect of neighbourhood income and maternal education on birth outcomes: a population-based study

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Luo, Z.-C.·2006·Canadian Medical Association Journal

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Abstract

BACKGROUND: Maternal socioeconomic status (SES) is an important determinant of inequity in maternal and fetal health. We sought to determine the extent to which associations between adverse birth outcomes and SES can be identified using individual-level measures (maternal level of education) and community-level measures (neighbourhood income). METHODS: In Quebec, the birth registration form includes a field for the mother's years of education. Using data from birth registration certificates, we identified all births from 1991 to 2000. Using maternal postal codes that can be linked to census enumeration areas, we determined neighbourhood income levels that reflect SES. RESULTS: Lower levels of both maternal education and neighbourhood income were associated with elevated crude risks of preterm birth, small-for-gestational-age (SGA) birth, stillbirth and neonatal and postneonatal death. The effects of maternal education were stronger than, and independent of, those of neighbourhood income. Compared with women in the highest neighbourhood income quintile, women in the lowest quintile were significantly more likely to have a preterm birth (adjusted odds ratio [OR] 1.14, 95% confidence interval [CI] 1.10-1.17), SGA birth (OR 1.18, 95% CI 1.15-1.21) or stillbirth (OR 1.30, 95% CI 1.13-1.48); compared with mothers who had completed community college or at least some university, mothers who had not completed high school were significantly more likely to have a preterm birth (adjusted OR 1.48, 95% CI 1.44-1.52), SGA birth (OR 1.86, 95% CI 1.82-1.91) or stillbirth (OR 1.54, 95% CI 1.36-1.74). INTERPRETATION: Individual and, to a lesser extent, neighbourhood-level SES measures are independent indicators for subpopulations at risk of adverse birth outcomes. Women with lower education levels and those living in poorer neighbourhoods are more vulnerable to adverse birth outcomes and may benefit from heightened clinical vigilance and counselling.

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Authors: Luo, Z.-C.
Affiliations: McGill University (CA)
Corresponding author: Luo, Z.-C.
ORCID: Luo, Z.-C.
Venue: Canadian Medical Association Journal
Publisher: CMA Impact Inc.
Published: 2006-05-09
Volume: 174
Issue: 10
Pages: 1415-1420
ISSN: 0820-3946 (ISSN-L)
1488-2329
DOI: 10.1503/cmaj.051096
PMC: PMC1455422
OpenAlex: W2028048934
Semantic Scholar: ec82c60bb321557ff648b76322ebbdbd436fa00b
Cited by: 382
References: 22
Citations by year: 2026: 8 · 2025: 10 · 2024: 11 · 2023: 18 · 2022: 16 · 2021: 21 · 2020: 17 · 2019: 12 · 2018: 14 · 2017: 20 · 2016: 14 · 2015: 23 · 2014: 33 · 2013: 21 · 2012: 24
FWCI: 40.54
Type: journal article
Language: en
Open access: gold
doi.org
Locations: Canadian Medical Association Journal (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institutes of Health Research (2004-2005)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
Social Sciences › Health › Health disparities and outcomes
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords: neighborhood income, maternal education, socioeconomic status, birth outcomes, preterm birth, small-for-gestational-age birth, stillbirth, neonatal death, postneonatal mortality, health disparities, birth registration data
MeSH terms: Educational Status, Female, Humans, Income, Pregnancy, Pregnancy Outcome, Quebec, Rural Population, Urban Population, Odds Ratio, Premature Birth

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Effect of neighbourhood income and maternal education on birth outcomes: a population-based study

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