Summary
Objectives
In this study we examine the factors that are associated with adverse birth outcomes using a representative national sample. In our analysis we take into account factors which are related to the mother's behaviour during pregnancy and also consider the socio-economic circumstances of the family.
Methods
A series of logistic regression models are used to determine the increased risks of low birth weight, preterm, and small for gestational age births associated with maternal smoking, alcohol consumption and high blood pressure in relation to socio-economic factors, such as family dysfunction, social support, income adequacy, age, and education.
Results
All socio-economic factors showed gradients of maternal smoking during pregnancy while only mother's education and socio-economic status demonstrated gradients of alcohol use and high blood pressure. Maternal smoking, high blood pressure, higher levels of family dysfunction, and lower levels of mother's education were found to significantly increase the risk of an adverse birth outcome.
Conclusions
Interventions designed to mitigate the hazards of adverse birth outcomes should be designed to reflect the gradients of risky prenatal maternal behaviours associated with age, education, income, and family dysfunction.
Zusammenfassung
Fragestellung
In dieser Studie untersuchen wir anhand eines repräsentativen Datensatzes die Faktoren, die mit Risikogeburten (Frühgeburten, geringes Gewicht oder Unterentwicklung bei Geburt) assoziiert sind.
Methoden
In unserer Untersuchung berücksichtigen wir Faktoren, die mit dem Verhalten der Mutter während der Schwangerschaft und mit den sozialen und wirtschaftlichen Umständen der Familie in Verbindung stehen. Wir verwenden logistische Regressionsmodelle, um das erhöhte Risiko von geringem Geburtsgewicht, Frühgeburten und verminderter Fruchtentwicklung, das mit Nikotin- und Alkoholkonsum sowie hohem Blutdruck während der Schwangerschaft verbunden ist, mit sozio-ökonomischen Faktoren, wie Zerrüttungen in der Familie, sozialer Unterstützung, Einkommen, Alter und Ausbildung, zu bestimmen.
Ergebnisse
Während alle sozio-ökonomischen Variablen das Rauchen der Mutter während der Schwangerschaft erklären, finden wir für den Alkoholkonsum und hohen Blutdruck nur Unterschiede in Bezug auf Ausbildung und sozio-ökonomischen Status. Rauchen während der Schwangerschaft, hoher Blutdruck und niedrigerer Ausbildungsstand der Mutter sowie ein höherer Grad von Familienzerrüttung zeigen einen signifikanten Anstieg des Risikos einer Problemgeburt.
Schlussfolgerungen
Interventionen, die das Risiko von Problemgeburten zu mindern versuchen, soliten die unterschiedlichen Einflüsse, die mit Alter, Ausbildung, Einkommen, Familienstand und riskantem Verhalten der Mutter während der Schwangerschaft assoziiert sind, berücksichtigen.
Résumé
Objectifs
Dans cette étude, nous examinons les facteurs qui sont associés avec les résultats negatifs pour les naissances, en utilisant un échantillon national et représentatif.
Méthodes
Dans l'analyse, nous prenons en compte des facteurs qui sont liés avec le comportement de la mère pendant la grossesse, et aussi nous considérons les circonstances socio-économiques de la famille. Une série de modèles de régression logistique est exploitée pour déterminer les risques accrus de petits poids de naissance, naissance prématurée, et petite taille par rapport à l'âge gestationnel, qui sont associés avec le tabagisme maternel, la consommation d'alcool et la tension artérielle élevée, vis-à-vis des facteurs socio-économiques comme le dysfonctionnement familial, le soutien social, l'adéquation des revenus, l'âge et l'éducation.
Résultats
Tous les facteurs socio-économiques indiquent des courbes linéaires avec le tabagisme maternel pendant la grossesse, mais seulement l'éducation de la mère et le status socio-économique montrent des courbes linéaires avec la consommation de l'alcool et la tension artérielle élevée. On a trouvé que le tabagisme maternel, la tension artérielle élevée, le dysfonctionnement familiale élevé et le niveau bas d'éducation de la mère augmentent le risque d'un résultat negatif à la naissance.
Conclusions
Les interventions prévues pour réduire le risque des résultats négatifs à la naissance doivent tenir compte des relations entre des comportements maternels dangereux avant la naissance, ainsi que l'âge, l'éducation, le revenu, et le dysfonctionnement familial.
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Pevalin, D.J., Wade, T.J., Brannigan, A. et al. Beyond biology: The social context of prenatal behaviour and birth outcomes. Soz Präventivmed 46, 233–239 (2001). https://doi.org/10.1007/BF01593178
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DOI: https://doi.org/10.1007/BF01593178