Diego Erasun1, Jéssica Alonso-Molero2,3,4, Inés Gómez-Acebo5,6,7, Trinidad Dierssen-Sotos5,6,7, Javier Llorca5,7, José Schneider8. 1. University Hospital Marqués de Valdecilla, Santander, Spain. 2. Department of Preventive Medicine and Public Health, University of Cantabria, Avda. Herrera Oria s/n, 39011, Santander, Spain. alonsomoleroj@gmail.com. 3. IDIVAL, Santander, Spain. alonsomoleroj@gmail.com. 4. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. alonsomoleroj@gmail.com. 5. Department of Preventive Medicine and Public Health, University of Cantabria, Avda. Herrera Oria s/n, 39011, Santander, Spain. 6. IDIVAL, Santander, Spain. 7. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. 8. Universidad de Valladolid, Valladolid, Spain.
Abstract
BACKGROUND: Low birth weight rates are increasing in both developed and developing countries. Although several maternal factors have been identified as associated with low birth weight, little is known of economic or organization factors influencing this increase. This study aims to ascertain the twenty-first century relationships between the contextual country factors and low birth weight rates. METHODS: We analyse trends of low birth weight rates in Organisation for Economic Co-operation and Development (OECD) countries. Data from 2000 to 2015 were obtained from the OECD data base. Their relationships with demographic and economic variables, health habits, woman-related preventive measures, health care system organization and funding, health care work force and obstetric care were analysed using random-effects linear regression. RESULTS: Low birth weight rates are higher in Southern Europe (7.61%) and lower in Northern Europe (4.68%). Low birth weight rates escalated about 20% in Southern Europe and to less extent in Easter Europe (7%) and Asian/Oceanian countries, while remained stable in America, Central Europe and Northern Europe. Investment in health care, private health system coverage, ratios of paediatricians and obstetricians, average length of admission due to pregnancy or birth and Caesarean section rate were associated with higher low birth weight rates. Factors associated with lower low birth weight rates were health care coverage, public health system coverage, hospitals per million inhabitants, and ratios of health care workers, physicians, midwives and nurses. CONCLUSIONS: In OECD countries, LBW rates are related to contextual country characteristics such as GDP per capita, which is inversely related to LBW rate. Health care system factors, including health care coverage or investment in public health system, are directly associated with lower LBW rates.
BACKGROUND: Low birth weight rates are increasing in both developed and developing countries. Although several maternal factors have been identified as associated with low birth weight, little is known of economic or organization factors influencing this increase. This study aims to ascertain the twenty-first century relationships between the contextual country factors and low birth weight rates. METHODS: We analyse trends of low birth weight rates in Organisation for Economic Co-operation and Development (OECD) countries. Data from 2000 to 2015 were obtained from the OECD data base. Their relationships with demographic and economic variables, health habits, woman-related preventive measures, health care system organization and funding, health care work force and obstetric care were analysed using random-effects linear regression. RESULTS: Low birth weight rates are higher in Southern Europe (7.61%) and lower in Northern Europe (4.68%). Low birth weight rates escalated about 20% in Southern Europe and to less extent in Easter Europe (7%) and Asian/Oceanian countries, while remained stable in America, Central Europe and Northern Europe. Investment in health care, private health system coverage, ratios of paediatricians and obstetricians, average length of admission due to pregnancy or birth and Caesarean section rate were associated with higher low birth weight rates. Factors associated with lower low birth weight rates were health care coverage, public health system coverage, hospitals per million inhabitants, and ratios of health care workers, physicians, midwives and nurses. CONCLUSIONS: In OECD countries, LBW rates are related to contextual country characteristics such as GDP per capita, which is inversely related to LBW rate. Health care system factors, including health care coverage or investment in public health system, are directly associated with lower LBW rates.
Entities:
Keywords:
Caesarean section; Delivery; Developed countries; Health system; Low birth weight; Obstetric; Pediatricians
Authors: Sonia Silvestrin; Clécio Homrich da Silva; Vânia Naomi Hirakata; André A S Goldani; Patrícia P Silveira; Marcelo Z Goldani Journal: J Pediatr (Rio J) Date: 2013-06-26 Impact factor: 2.197
Authors: Sam Wilding; Nida Ziauddeen; Paul Roderick; Dianna Smith; Debbie Chase; Nick Macklon; Nuala McGrath; Mark Hanson; Nisreen A Alwan Journal: BMJ Open Date: 2019-07-29 Impact factor: 2.692