Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts
Por:
Ruiz M, Goldblatt P, Morrison J, Kukla L, Švancara J, Riitta-Järvelin M, Taanila A, Saurel-Cubizolles MJ, Lioret S, Bakoula C, Veltsista A, Porta D, Forastiere F, van Eijsden M, Vrijkotte TG, Eggesbø M, White RA, Barros H, Correia S, Vrijheid M, Torrent M, Rebagliato M, Larrañaga I, Ludvigsson J, Olsen Faresjö Å, Hryhorczuk D, Antipkin Y, Marmot M and Pikhart H
Publicada:
1 sep 2015
Resumen:
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.
Filiaciones:
Ruiz M:
Research Department of Epidemiology and Public Health, University College London, London, UK
Goldblatt P:
Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK
Morrison J:
Research Department of Epidemiology and Public Health, University College London, London, UK
Kukla L:
Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
Švancara J:
Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
Riitta-Järvelin M:
Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK Unit of Primary Care, Oulu University Hospital, Oulu, Finland Center for Life Course Epidemiology, Faculty of Medicine, University of Oulu, Oulu, Finland Institute of Health Sciences, University of Oulu, Oulu, Finland
Taanila A:
Biocenter Oulu, University of Oulu, Oulu, Finland
Saurel-Cubizolles MJ:
Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics, Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
Lioret S:
Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1153, Early Origin of the Child's Health and Development Team (ORCHAD), Center for Epidemiology and Statistics, Sorbonne Paris Cité, Paris Descartes University, Paris, France
Bakoula C:
First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
Veltsista A:
First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
Porta D:
Department of Epidemiology of the Lazio Regional Health System, Rome, Italy
Forastiere F:
Department of Epidemiology of the Lazio Regional Health System, Rome, Italy
van Eijsden M:
Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, Amsterdam, The Netherlands
Vrijkotte TG:
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
Eggesbø M:
Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
White RA:
Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
Barros H:
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
Correia S:
Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
Vrijheid M:
Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain
Torrent M:
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain IB-Salut Menorca Health Area, Balearic Islands, Spain
:
Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Barcelona, Spain Departamento de Medicina, Universitat Jaume I, Castellon, Spain
Larrañaga I:
Public Health Department of Gipuzkoa, Gipuzkoa, Spain BIODONOSTIA Health Research Institute, San Sebastian, Spain
Ludvigsson J:
Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
Olsen Faresjö Å:
Department of Medicine and Health Sciences, Linköping University, Linköping, Sweden
Hryhorczuk D:
Center for Global Health, University of Illinois College of Medicine, Chicago, Illinois, USA
Antipkin Y:
Institute of Pediatrics, Obstetrics, and Gynecology, Kyiv, Ukraine
Marmot M:
Research Department of Epidemiology and Public Health, University College London, London, UK Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK
Pikhart H:
Research Department of Epidemiology and Public Health, University College London, London, UK
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