Akshay Swaminathan1, Marianne Lahaie Luna2, Ruth Rennicks White3, Graeme Smith4, Marc Rodger5, Shi Wu Wen6, Mark Walker7, Daniel J Corsi8,9. 1. Flatiron Health, New York, NY, USA. 2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. 3. OMNI Research Group, Ottawa Hospital Research Institute, Ottawa, ON, Canada. 4. Department of Obstetrics and Gynecology, Queen's Perinatal Research Unit, Kingston General Hospital, Queens University, Kingston, ON, Canada. 5. Faculty of Medicine, McGill University, Montreal, QC, Canada. 6. OMNI Research Group, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. 7. OMNI Research Group, Ottawa Hospital Research Institute, and Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada. 8. OMNI Research Group, Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada. 9. CHEO Research Institute, Ottawa, ON, Canada.
Abstract
BACKGROUND: Education is considered one of the most robust determinants of health. However, it is unclear whether maternal education and paternal education have differential impacts on perinatal health outcomes. We assess maternal and paternal education differences and their association with adverse birth outcomes in a large birth cohort from Ontario, Canada. METHODS: The OaK Birth Cohort recruited patients from Ontario, Canada, between October 2002 and April 2009. We recruited mothers were recruited between 12 and 20 weeks' gestation and collected both mother and infant data. The final sample size of the cohort was 8,085 participants. We use logistic regression to model the probability of preterm birth (less than 34 and 37 weeks' gestation), small-for-gestational-age (SGA), or stillbirth as a function of maternal and paternal educational attainment. We adjust for household-level income, maternal and paternal race and ethnicity, and compare the strength of the association between maternal and paternal education on outcomes using Wald tests. RESULTS: 7,928 mother-father-offspring triads were available for the current analysis. 75% of mothers and fathers had college or university level education, and 8.7% of mothers experienced preterm delivery. Compared to mothers with college or university education, mothers with a high school education had an odds ratio of 1.37 (95% CI: 1.01-1.87) for SGA. Paternal education was not associated with infant outcomes. Comparing the odds ratios for maternal education and paternal education showed a stronger association than paternal education at the high school level for SGA birth (difference in odds ratio: 1.95, 95% CI: 1.13-3.36, p = .016) among women at least 25 years old. CONCLUSION: Maternal education was associated with SGA, and this effect was more robust than paternal education, but both associations were weaker than previously reported.
BACKGROUND: Education is considered one of the most robust determinants of health. However, it is unclear whether maternal education and paternal education have differential impacts on perinatal health outcomes. We assess maternal and paternal education differences and their association with adverse birth outcomes in a large birth cohort from Ontario, Canada. METHODS: The OaK Birth Cohort recruited patients from Ontario, Canada, between October 2002 and April 2009. We recruited mothers were recruited between 12 and 20 weeks' gestation and collected both mother and infant data. The final sample size of the cohort was 8,085 participants. We use logistic regression to model the probability of preterm birth (less than 34 and 37 weeks' gestation), small-for-gestational-age (SGA), or stillbirth as a function of maternal and paternal educational attainment. We adjust for household-level income, maternal and paternal race and ethnicity, and compare the strength of the association between maternal and paternal education on outcomes using Wald tests. RESULTS: 7,928 mother-father-offspring triads were available for the current analysis. 75% of mothers and fathers had college or university level education, and 8.7% of mothers experienced preterm delivery. Compared to mothers with college or university education, mothers with a high school education had an odds ratio of 1.37 (95% CI: 1.01-1.87) for SGA. Paternal education was not associated with infant outcomes. Comparing the odds ratios for maternal education and paternal education showed a stronger association than paternal education at the high school level for SGA birth (difference in odds ratio: 1.95, 95% CI: 1.13-3.36, p = .016) among women at least 25 years old. CONCLUSION: Maternal education was associated with SGA, and this effect was more robust than paternal education, but both associations were weaker than previously reported.
Authors: Carolina Fioroni Ribeiro da Silva; Valentina Menici; Eloisa Tudella; Elena Beani; Veronica Barzacchi; Roberta Battini; Alessandro Orsini; Giovanni Cioni; Giuseppina Sgandurra Journal: Int J Environ Res Public Health Date: 2022-08-31 Impact factor: 4.614