Socioeconomic inequalities in reproductive outcomes in the Italian NINFEA birth cohort and the Piedmont Birth Registry.
Disuguaglianze socioeconomiche negli esiti riproduttivi nella coorte italiana di nuovi nati NINFEA e nel Registro delle nascite piemontese.
socioeconomic position; birth cohorts; premature birth; low birth weight; income.
Journal
Epidemiologia e prevenzione
ISSN: 1120-9763
Titre abrégé: Epidemiol Prev
Pays: Italy
ID NLM: 8902507
Informations de publication
Date de publication:
Historique:
entrez:
8
1
2021
pubmed:
9
1
2021
medline:
24
6
2021
Statut:
ppublish
Résumé
socioeconomic inequalities in reproductive outcomes have been consistently reported in several countries. In a European collaborative study conducted in 2012 whose aim was to investigate the association between socioeconomic position (SEP), measured through maternal education, and preterm delivery inconsistent results were found for the NINFEA birth cohort. However, NINFEA contributed to that study with the first 2,500 pregnancies only, and estimates were not adjusted for any potential confounders assuming that SEP is a distal exposure, that could not be affected by other preterm risk factors. to investigate the relationship between SEP and the reproductive outcomes using the entire NINFEA cohort and compare the results with the population-based Piedmont Birth Registry (PBR), accounting for potential baseline collider bias both in the cohort and in the registry. observational study. 5,323 NINFEA singletons, whose mothers registered into the study before the 36th week of gestation, were analysed. Analyses on maternal education were replicated in the 2011 PBR of 35,318 singletons live births. Factors affecting the likelihood of being a member of the NINFEA study or becoming pregnant in the general population were treated as potential confounders to adjust for baseline collider bias. the association of maternal education and a recently developed household income indicator with both preterm delivery (<37th weeks of gestation) and low birth weight (<2,500 gr) were analysed. in the NINFEA cohort, low SEP was positively associated with both preterm delivery and low birth weight, with slightly stronger associations for household income, especially on low birth weight. Results were consistent with those obtained in the PBR data, where an inverse relationship between maternal education and the two reproductive outcomes was found. In both populations, there was confounding due to maternal age and parity, showing that independently of the nature of the source population, baseline factors that affect the probability of being a member of such source population have to be accounted for to allow causal inference. low SEP is associated with adverse reproductive outcomes in a contemporary Italian population.
Sections du résumé
BACKGROUND
BACKGROUND
socioeconomic inequalities in reproductive outcomes have been consistently reported in several countries. In a European collaborative study conducted in 2012 whose aim was to investigate the association between socioeconomic position (SEP), measured through maternal education, and preterm delivery inconsistent results were found for the NINFEA birth cohort. However, NINFEA contributed to that study with the first 2,500 pregnancies only, and estimates were not adjusted for any potential confounders assuming that SEP is a distal exposure, that could not be affected by other preterm risk factors.
OBJECTIVES
OBJECTIVE
to investigate the relationship between SEP and the reproductive outcomes using the entire NINFEA cohort and compare the results with the population-based Piedmont Birth Registry (PBR), accounting for potential baseline collider bias both in the cohort and in the registry.
DESIGN
METHODS
observational study.
SETTING AND PARTICPANTS
UNASSIGNED
5,323 NINFEA singletons, whose mothers registered into the study before the 36th week of gestation, were analysed. Analyses on maternal education were replicated in the 2011 PBR of 35,318 singletons live births. Factors affecting the likelihood of being a member of the NINFEA study or becoming pregnant in the general population were treated as potential confounders to adjust for baseline collider bias.
MAIN OUTCOME MEASURES
METHODS
the association of maternal education and a recently developed household income indicator with both preterm delivery (<37th weeks of gestation) and low birth weight (<2,500 gr) were analysed.
RESULTS
RESULTS
in the NINFEA cohort, low SEP was positively associated with both preterm delivery and low birth weight, with slightly stronger associations for household income, especially on low birth weight. Results were consistent with those obtained in the PBR data, where an inverse relationship between maternal education and the two reproductive outcomes was found. In both populations, there was confounding due to maternal age and parity, showing that independently of the nature of the source population, baseline factors that affect the probability of being a member of such source population have to be accounted for to allow causal inference.
CONCLUSIONS
CONCLUSIONS
low SEP is associated with adverse reproductive outcomes in a contemporary Italian population.
Identifiants
pubmed: 33415956
doi: 10.19191/EP20.5-6.S1.P136.083
pii: 5011
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM