Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts

• Authors: RUIZ Milagros; GOLDBLATT Peter; MORRISON Joana; KUKLA Lubomír; ŠVANCARA Jan; RIITTA-JÄRVELIN Marjo; TAANILA Anja; SAUREL-CUBIZOLLES Marie-Josephe; LIORET Sandrine; BAKOULA Chryssa; VELTSISTA Alexandra; PORTA Daniela; FORASTIERE Francesco; EIJSDEN Manon van; VRIJKOTTE Tanja G M; EGGESBO Merete; WHITE Richard A; BARROS Henrique; CORREIA Sofia; VRIJHEID Martine; TORRENT Maties; REBAGLIATO Marisa; LARRANAGA Isabel; LUDVIGSSON Johnny; FARESJÖ Ashild Olsen; HRYHORCZUK Daniel; ANTIPKIN Youriy; MARMOT Michael; PIKHART Hynek
• Year of publication: 2015
• Type: Article in Periodical
• Magazine / Source: Journal of Epidemiology and Community Health
• MU Faculty or unit: Faculty of Science
• Web: http://jech.bmj.com/content/69/9/826
• Doi: http://dx.doi.org/10.1136/jech-2014-205387
• Field: Hygiene
• Keywords: FOLLOW-UP; HEALTH; INEQUALITIES; MORTALITY; CHILDREN; PROFILE; DISEASE; WEIGHT; LIFE
• Description: Background A healthy start to life is a major priority in efforts to reduce health inequalities across Europe, with important implications for the health of future generations. There is limited combined evidence on inequalities in health among newborns across a range of European countries. Methods Prospective cohort data of 75 296 newborns from 12 European countries were used. Maternal education, preterm and small for gestational age births were determined at baseline along with covariate data. Regression models were estimated within each cohort and meta-analyses were conducted to compare and measure heterogeneity between cohorts. Results Mother's education was linked to an appreciable risk of preterm and small for gestational age (SGA) births across 12 European countries. The excess risk of preterm births associated with low maternal education was 1.48 (1.29 to 1.69) and 1.84 (0.99 to 2.69) in relative and absolute terms (Relative/Slope Index of Inequality, RII/SII) for all cohorts combined. Similar effects were found for SGA births, but absolute inequalities were greater, with an SII score of 3.64 (1.74 to 5.54). Inequalities at birth were strong in the Netherlands, the UK, Sweden and Spain and marginal in other countries studied. Conclusions This study highlights the value of comparative cohort analysis to better understand the relationship between maternal education and markers of fetal growth in different settings across Europe.

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