Family socioeconomic position and abnormal birth weight: evidence from a Chinese birth cohort

  • Si Tu
  • Ao-Lin Wang
  • Mei-Zhen Tan
  • Jin-Hua Lu
  • Jian-Rong He
  • Song-Ying Shen
  • Dong-Mei Wei
  • Min-Shan Lu
  • Shiu Lun Au Yeung
  • Hui-Min Xia
  • Xiu QiuEmail author
Original Article



Birth weight is a strong determinant of infant short- and long-term health outcomes. Family socioeconomic position (SEP) is usually positively associated with birth weight. Whether this association extends to abnormal birth weight or there exists potential mediator is unclear.


We analyzed data from 14,984 mother-infant dyads from the Born in Guangzhou Cohort Study. We used multivariable logistic regression to assess the associations of a composite family SEP score quartile with macrosomia and low birth weight (LBW), and examined the potential mediation effect of maternal pre-pregnancy body mass index (BMI) using causal mediation analysis.


The prevalence of macrosomia and LBW was 2.62% (n = 392) and 4.26% (n = 638). Higher family SEP was associated with a higher risk of macrosomia (OR 1.30, 95% CI 0.93–1.82; OR 1.53, 95% CI 1.11–2.11; and OR 1.59, 95% CI 1.15–2.20 for the 2nd, 3rd, and 4th SEP quartile respectively) and a lower risk of LBW (OR 0.69, 95% CI 0.55–0.86; OR 0.76, 95% CI 0.61–0.94; and OR 0.61, 95% CI 0.48–0.77 for the 2nd, 3rd, and 4th SEP quartile respectively), compared to the 1st SEP quartile. We found that pre-pregnancy BMI did not mediate the associations of SEP with macrosomia and LBW.


Socioeconomic disparities in fetal macrosomia and LBW exist in Southern China. Whether the results can be applied to other populations should be further investigated.


Birth cohort Low birth weight Macrosomia Socioeconomic position 



We are grateful to all the mothers and their families who have participated in BIGCS and all obstetric care providers who assisted in the implementation of the study. We also wish to thank Allison Gaines from University of Oxford for polishing the language of the paper.

Author contributions

XQ and HX conceived and designed the ongoing cohort study. ST, SS, DW, and ML collected the data. ST, AW, JL, and JH designed the statistical analysis in this paper. ST drafted and revised the manuscript. AW, MT, JH, and SLAY provided the technical and analysis advice and revised the manuscript. XQ supervised and provide specialist support for the manuscript. ST and AW contributed equally to this paper. All authors revised the important intellectual content critically and approved the final version.


This work was supported by National Natural Science Foundation of China (Grant Numbers 81673181, 81703244, and 81803251).

Compliance with ethical standards

Ethical approval

The Born in Guangzhou Cohort Study was reviewed and approved by the Institutional Ethics Committee of the Guangzhou Women and Children’s Medical Center.

Conflict of interest

No financial or nonfinancial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

Supplementary material

12519_2019_279_MOESM1_ESM.docx (20 kb)
Supplementary file1 (DOCX 19 kb)


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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2019

Authors and Affiliations

  • Si Tu
    • 1
    • 2
    • 3
  • Ao-Lin Wang
    • 1
    • 4
  • Mei-Zhen Tan
    • 5
  • Jin-Hua Lu
    • 1
    • 2
  • Jian-Rong He
    • 1
    • 2
    • 6
  • Song-Ying Shen
    • 1
  • Dong-Mei Wei
    • 1
    • 2
  • Min-Shan Lu
    • 1
    • 2
  • Shiu Lun Au Yeung
    • 1
    • 7
  • Hui-Min Xia
    • 1
    • 3
  • Xiu Qiu
    • 1
    • 2
    • 8
    Email author
  1. 1.Division of Birth Cohort Study, Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou 510623China
  2. 2.Department of Women and Child Health Care, Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina
  3. 3.Department of Neonatal Surgery, Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina
  4. 4.Program on Reproductive Health and the Environment and Bakar Computational Health Sciences InstituteUniversity of CaliforniaSan FranciscoUSA
  5. 5.Department of Child Health Care, Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina
  6. 6.Nuffield Department of Women’s and Reproductive HealthUniversity of OxfordOxfordUK
  7. 7.School of Public Health, Li Ka Shing Faculty of MedicineThe University of Hong KongHong KongChina
  8. 8.Department of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhouChina

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