Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts
2015 (English)In: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 69, no 9, 826-833 p.Article in journal (Refereed) Published
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 Mothers 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.
Place, publisher, year, edition, pages
BMJ Publishing Group , 2015. Vol. 69, no 9, 826-833 p.
Clinical Medicine Basic Medicine
IdentifiersURN: urn:nbn:se:liu:diva-121099DOI: 10.1136/jech-2014-205387ISI: 000359388800003PubMedID: 25911693OAI: oai:DiVA.org:liu-121099DiVA: diva2:851858
Funding Agencies|European Unions Seventh Framework Programme grant, as part of The Determinants to Reduce Health Inequity Via Early Childhood, Realising Fair Employment, and Social Protection (DRIVERS) research programme ; Ministry of Education of the Czech Republic [LM2011028, LO1214]; Grant Agency of the Masaryk University [MUNI/M/1075/2013]; Academy of Finland, Biocenter, University of Oulu, Finland [NFBC8586]; European Commission (EURO-BLCS) [QLG1-CT-2000-01643]; EU FP7 EurHEALTHAgeing ; Medical Research Council, UK (PrevMetSyn/SALVE); MRC Centenary Early Career Award2015-09-072015-09-072016-03-23Bibliographically approved