E Raum1, B Arabin, M Schlaud, U Walter, F W Schwartz. 1. Department of Epidemiology, Social Medicine and Health System Research, Hanover Medical School, Hanover, Germany. raum@epi.mh-hannover.de
Abstract
BACKGROUND: Objective of this re-analysis of datasets from former East and West Germany was to examine the influence of maternal education on intrauterine growth in two different political and social systems. METHODS: Information on socio-demographic or lifestyle factors and pregnancy outcome was available for 3374 liveborn singletons from West Germany (1987/88) and 3070 from East Germany (1990/91). Multiple logistic regression was used to estimate the association between maternal education and the risk of delivering a small-for-gestational-age (SGA) newborn below the 10th percentile of birthweight. RESULTS: Women with the lowest education had a significantly elevated risk of SGA newborns compared to women with the highest education in West (odds ratio [OR] = 2.58, 95% CI : 1.17-5.67) and East Germany (OR = 2.77, 95% CI : 1.54- 5.00). The distribution of factors known to influence intrauterine growth varied with education in both states. After adjusting for these factors, women with the lowest educational level still had a higher risk of SGA birth: OR (West) = 2.02, 95% CI : 0.87-4.72; OR (East) = 1.95, 95% CI : 1.02-3.74. CONCLUSIONS: Our findings support the assumption that in former socialist countries health inequalities as a result of social inequalities existed.
BACKGROUND: Objective of this re-analysis of datasets from former East and West Germany was to examine the influence of maternal education on intrauterine growth in two different political and social systems. METHODS: Information on socio-demographic or lifestyle factors and pregnancy outcome was available for 3374 liveborn singletons from West Germany (1987/88) and 3070 from East Germany (1990/91). Multiple logistic regression was used to estimate the association between maternal education and the risk of delivering a small-for-gestational-age (SGA) newborn below the 10th percentile of birthweight. RESULTS:Women with the lowest education had a significantly elevated risk of SGA newborns compared to women with the highest education in West (odds ratio [OR] = 2.58, 95% CI : 1.17-5.67) and East Germany (OR = 2.77, 95% CI : 1.54- 5.00). The distribution of factors known to influence intrauterine growth varied with education in both states. After adjusting for these factors, women with the lowest educational level still had a higher risk of SGA birth: OR (West) = 2.02, 95% CI : 0.87-4.72; OR (East) = 1.95, 95% CI : 1.02-3.74. CONCLUSIONS: Our findings support the assumption that in former socialist countries health inequalities as a result of social inequalities existed.
Authors: Robie Sterling; J Jaime Miranda; Robert H Gilman; Lilia Cabrera; Charles R Sterling; Caryn Bern; William Checkley Journal: Am J Phys Anthropol Date: 2012-05-03 Impact factor: 2.868
Authors: A Matijasevich; C G Victora; D A Lawlor; J Golding; A M B Menezes; C L Araújo; A J D Barros; I S Santos; F C Barros; G Davey Smith Journal: J Epidemiol Community Health Date: 2010-07-13 Impact factor: 3.710
Authors: Emma Pomeroy; Jonathan C K Wells; Tim J Cole; Michael O'Callaghan; Jay T Stock Journal: Am J Phys Anthropol Date: 2014-12-13 Impact factor: 2.868
Authors: Alamgir Kabir; Rebecca D Merrill; Abu Ahmed Shamim; Rolf D W Klemn; Alain B Labrique; Parul Christian; Keith P West; Mohammed Nasser Journal: PLoS One Date: 2014-04-07 Impact factor: 3.240