The influence of socioeconomic status on stillbirth risk in Sweden
The influence of socioeconomic status on stillbirth risk in Sweden
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DOI：
10.1093/ije/30.6.1296
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发表时间：
2001-12-01
影响因子：
7.7
通讯作者：
Cnattingius, S
中科院分区：
文献类型：
--
作者：
Stephansson, O;Dickman, PW;Cnattingius, S
低社会经济地位（SES）通常与死产风险增加有关，但其机制很少被调查。我们的目的是研究社会经济地位与死产风险之间的关系，并评估风险的差异是否由其他产妇社会人口统计学或人体测量学特征、生活方式差异或产前护理的参与介导。方法以人群为基础的个体匹配病例对照研究，包括1987-1996年出生的瑞典初产妇女中702例死产和702例对照。我们估计了不同类型SES的死产风险和死产亚组。通过条件逻辑回归估计95% CI的比值比（OR）用于近似相对风险。根据母亲的年龄、身高、体重指数、吸烟情况，以及必要时母亲的出生国，对这些估计进行了调整。结果与高级白领女性相比，调整后的死产风险为：非熟练蓝领2.2 (95% CI: 1.3 ~ 3.7)，熟练蓝领2.4 (95% CI: 1.3 ~ 4.1)，低级白领1.9 (95% CI: 1.2 ~ 3.2)，中级白领1.4 （95% CI: 0.9 ~ 2.4）。当我们进一步调整产前保健的出席率、以前的生育史或排除患有孕产妇疾病和妊娠相关疾病的妊娠时，这些风险并没有实质性的改变。低社会阶层与足月产前和产时死产的风险最相关。结论低SES会增加死产的风险。我们研究的任何因素都无法解释这种关联，其根本原因也尚不清楚。
Background Low socioeconomic status (SES) is generally associated with increased risk of stillbirth, but the mechanisms have rarely been investigated. Our aim was to study the association between SES and risk of stillbirth, and to assess whether any differences in risk are mediated by other maternal socio-demographic or anthropometrical characteristics, differences in lifestyle, or attendance at antenatal care.Methods Population-based individually-matched case-control study including 702 cases of stillbirth and 702 controls among Swedish primiparous women giving birth 1987-1996. We estimated the risk of stillbirth, and subgroups of stillbirth, for various categories of SES. Odds ratios (OR) with 95% CI estimated by conditional logistic regression, were used to approximate the relative risk. The estimates were adjusted for maternal age, height, body mass index, cigarette smoking, and when necessary mother's country of birth.Results Compared with women who were high level white-collar workers, the adjusted risks of stillbirth were as follows: unskilled blue-collar workers, 2.2 (95% CI: 1.3-3.7), skilled blue-collar workers, 2.4 (95% CI: 1.3-4.1), low level white-collar workers, 1.9 (95% CI: 1.2-3.2), and intermediate level white-collar workers 1.4 (95% CI: 0.9-2.4). These risks were not substantially changed when we further adjusted for attendance at antenatal care, previous reproductive history, or excluded pregnancies with maternal diseases, and pregnancy-related disorders. Low social class was most associated with risks of term antepartum and intrapartum stillbirths.Conclusions Low SES increases the risk of stillbirth. The association could not be explained by any of the factors we studied, and the underlying reasons remain unclear.