Trends in socioeconomic differences in Finnish perinatal health 1991-2006
Trends in socioeconomic differences in Finnish perinatal health 1991-2006
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DOI：
10.1136/jech.2008.079921
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发表时间：
2009-06-01
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.;Rahkonen, O.;Hemminki, E.
背景：20 世纪 90 年代末芬兰围产期健康的社会经济差异有所缩小。研究了 1990 年代末在芬兰观察到的围产期健康社会经济差异的缩小是否在 2000 年 6 月继续存在。方法：数据基于 1991 年至 2006 年芬兰医学出生登记册中记录的 965 443 名新生儿和 931 285 名单身人士。有关社会经济地位的信息基于母亲的职业。采用六种不同指标来衡量围产期健康状况。 结果：研究期间早产儿、低出生体重儿和小胎龄儿的比例保持稳定，而大胎龄儿和围产儿死亡的比例则有所下降。对母亲背景变量进行调整后，早产儿和低出生体重儿的社会经济差异在 20 世纪 90 年代末有所下降，此后一直保持在较低水平。 2003年6月，蓝领工人的早产风险比上层白领工人高14%（95% CI 7%至22%），低出生体重风险比上层白领工人高25%（95% CI 16%至34%）。对于SGA，社会经济差异保持不变，2003-6 年蓝领工人的超额风险为44%（95% CI 31% 至58%）。对于 LGA，社会经济差异加大，超额风险最高的是低层白领（23%，95% CI 15% 至 33%）和蓝领工人（24%，95% CI 14% 至 36%）。围产期死亡率的差异直到 20 世纪 90 年代末才有所下降，但此后有所增加。 2003年6月，低层白领和蓝领工人的超额风险最高：分别为46%（95% CI 20%至77%）和44%（95% CI 13%至83%）。结论：围产期健康结果的社会不平等趋势按指标存在差异。 20 世纪 90 年代社会经济差异缩小的积极趋势似乎已经结束。
Background: Socioeconomic differences in perinatal health decreased in Finland in the late 1990s. Whether the decreasing socioeconomic differences in perinatal health observed in Finland in the late 1990s have continued in 2000-6 was studied.Methods: The data were based on 965 443 births and 931 285 singletons recorded between 1991 and 2006 in the Finnish Medical Birth Register. Information on socioeconomic position was based on maternal occupation. Perinatal health was measured with six different indicators.Results: The proportions of preterm, low birthweight and SGA (small-for-gestational-age) births remained stable during the study period, but decreased for LGA (large-for-gestational-age) births and perinatal death. After adjustment for maternal background variables, the socioeconomic differences in preterm and low-birthweight births decreased in the late 1990s and remained low thereafter. In 2003-6, blue-collar workers had a 14% (95% CI 7% to 22%) higher risk for preterm birth and a 25% (95% CI 16% to 34%) higher risk for low birthweight than upper white-collar workers. For SGA, the socioeconomic differences remained unchanged, and the excess risk for blue-collar workers was 44% (95% CI 31% to 58%) in 2003-6. For LGA, the socioeconomic differences increased, and the highest excess risks were obtained among lower white-collar (23%, 95% CI 15% to 33%) and blue-collar workers (24%, 95% CI 14% to 36%). The differences in perinatal mortality decreased until the late 1990s, but increased thereafter. In 2003-6, lower white-collar and blue-collar workers had the highest excess risks: 46% (95% CI 20% to 77%) and 44% (95% CI 13% to 83%), respectively.Conclusions: The trends in social inequality in perinatal health outcomes were diverging by indicator. The positive trend on diminishing socioeconomic differences found in the 1990s seems to have come to an end.