Register based monitoring shows decreasing socioeconomic differences in Finnish perinatal health
Register based monitoring shows decreasing socioeconomic differences in Finnish perinatal health
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DOI：
10.1136/jech.57.6.433
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发表时间：
2003-06-01
影响因子：
6.3
通讯作者：
Hemminki, E
中科院分区：
文献类型：
--
作者：
Gissler, M;Meriläinen, J;Hemminki, E
研究目的：已经进行了几项关于社会经济地位对婴儿结局差异的研究，但这些研究通常是基于特别的数据联系。本文的目的是调查是否可以定期监测使用常规收集的数据从一个单一registration.Design和设置：自1990年10月以来，芬兰医疗出生登记（MBR）的围产期健康的社会经济差异，包括产妇职业的数据。编制了一个专门的计算机程序，将职业名称转换为职业代码和社会经济地位。围产期健康是衡量五个不同的指标。芬兰MBR数据1991年至1999年（n=565 863新生儿）用于研究。研究期间分为三个，三年期间研究时间trends.Results：职业代码派生的95%的妇女，但它是不可能定义的社会经济地位的22%的妇女，包括，例如，学生和家庭主妇（组“其他”）。对于其他人，数据显示在所有围产期健康指标方面存在社会经济差异。在社会经济地位最低的人群中，母亲吸烟可解释高达一半的围产期不良结局的超额风险。在1990年代，社会经济差异缩小：最低社会经济群体的婴儿结局有所改善，但其他群体保持在同一水平，甚至恶化。当比较最低组和最高组时，根据母亲背景特征调整的早产儿的比值比（OR）至少减半（从1991-1993年的1.32（95%置信区间1.24至1.43）降至1.16（1997-1999年为1.08至1.25）（从1.49（1.36至1.63）至1.25）（1.17至1.40））和围产期死亡率（从1.79（1.44至2.21）至1.33（1.07至1.66））.结论：芬兰存在围产期健康结果方面的社会不平等，但在1990年代似乎有所减少。这些数据表明，定期收集的出生登记数据为研究围产期社会经济健康差异提供了良好的来源，但主要由于社会经济地位难以分类的妇女群体众多，这种不确定性仍然存在。
Study objective: Several studies on differences in infant outcome by socioeconomic position have been done, but these have usually been based on ad hoc data linkages. The aim of this paper was to investigate whether socioeconomic differences in perinatal health in Finland could be regularly monitored using routinely collected data from one single register.Design and setting: Since October 1990, the Finnish Medical Birth Register (MBR) has included data on maternal occupation. A special computer program that converted the occupation name into an occupational code and into a socioeconomic position was prepared. Perinatal health was measured with five different indicators. The Finnish MBR data for years 1991 to 1999 (n=565 863 newborns) were used in the study. The study period was divided into three, three year periods to study time trends.Results: An occupational code was derived for 95% of women, but it was not possible to define a socioeconomic position for 22% of women, including, for example, students and housewives (the group "Others"). For the rest, the data showed socioeconomic differences in all perinatal health indicators. Maternal smoking explained up to half of the excess risk for adverse perinatal outcome in the lowest socioeconomic group. The socioeconomic differences narrowed during the 1990s: infant outcome improved in the lowest socioeconomic group, but remained at the same level or even deteriorated in other groups. When comparing the lowest group with the highest group, the odds ratios (OR) adjusted for maternal background characteristics at least halved for prematurity (from 1.32 (95% confidence intervals 1.24 to 1.43) in 1991-1993 to 1.16 (1.08 to 1.25) in 1997-1999), for low birth weight (from 1.49 (1.36 to 1.63) to 1.25 (1.17 to 1.40)), and for perinatal mortality (from 1.79 (1.44 to 2.21) to 1.33 (1.07 to 1.66)).Conclusions: Social inequality in perinatal health outcomes exists in Finland, but seems to have diminished in the 1990s. These data showed that routinely collected birth register data provide a good source for studies on socioeconomic health differences in the perinatal period, but that uncertainty, mainly attributable to the large group of women with difficult to classify socioeconomic status, remains.