Literature DB >> 18160387

Neonatal and postneonatal mortality by maternal education--a population-based study of trends in the Nordic countries, 1981-2000.

Annett Arntzen1, Laust Mortensen, Ole Schnor, Sven Cnattingius, Mika Gissler, Anne-Marie Nybo Andersen.   

Abstract

BACKGROUND: This study examined changes in the educational gradients in neonatal and postneonatal mortality over a 20-year period in the four largest Nordic countries.
METHODS: The study populations were all live-born singleton infants with gestational age of at least 22 weeks from 1981 to 2000 (Finland 1987-2000). Information on births and infant deaths from the Medical Birth Registries was linked to information from census statistics. Numbers of eligible live-births were: Denmark 1 179 831, Finland 834 299 (1987-2000), Norway 1 017 168 and Sweden 1 971 645. Differences in mortality between education groups were estimated as risk differences (RD), relative risks (RR) and index of inequality ratio (RII).
RESULTS: Overall, rates of infant mortality were in Denmark 5.9 per 1000 live-births, in Finland 4.2 (1987-2000), in Norway 5.3 and in Sweden 4.7. Overall the mortality decreased in all educational groups, and the educational level increased in the study period. The time-trends differed between neonatal and postneonatal death. For neonatal death, both the absolute and relative educational differences decreased in Finland and Sweden, increased in Denmark, whereas in Norway a decrease in absolute differences and a slight increase in relative differences occurred. For postneonatal death, the relative educational differences increased in all countries, whereas the absolute differences decreased.
CONCLUSIONS: All educational groups experienced a decline in infant mortality during the period under study. Still, the inverse association between maternal education and RR of postneonatal death has become more pronounced in all Nordic countries.

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Year:  2007        PMID: 18160387     DOI: 10.1093/eurpub/ckm125

Source DB:  PubMed          Journal:  Eur J Public Health        ISSN: 1101-1262            Impact factor:   3.367


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