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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

Ruiz, Milagros
Autor Ruiz, Milagros Research Department of Epidemiology and Public Health, University College London, London, UK
Goldblatt, Peter
Autor Goldblatt, Peter Research Department of Epidemiology and Public Health, UCL Institute of Health Equity, University College London, London, UK
Morrison, Joana
Autor Morrison, Joana Research Department of Epidemiology and Public Health, University College London, London, UK
Kukla, Lubomír
Autor Kukla, Lubomír Faculty of Science, Research Centre for Toxic Compounds in the Environment (RECETOX), Masaryk University, Brno, Czech Republic
Švancara, Jan
Autor Švancara, Jan 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, Marjo
Autor Riitta-Järvelin, Marjo 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, Anja
Autor Taanila, Anja Biocenter Oulu, University of Oulu, Oulu, Finland
Saurel-Cubizolles, Marie-Josèphe
Autor Saurel-Cubizolles, Marie-Josèphe 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, Sandrine
Autor Lioret, Sandrine 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, Chryssa
Autor Bakoula, Chryssa First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece

Journal of epidemiology and community health. 2015 ; 69 (9) : 826-33. [pub] 20150424

J Epidemiol Community Health
ISSN 1470-2738
Medvik
Zdroj

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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