Social class, ethnicity and other risk factors for small for gestational age and preterm delivery in The Netherlands.
Social class and ethnicity are important risk factors for small-for-gestational-age and preterm delivery in many countries. This study was performed to assess whether this is also the case in the Netherlands, a country with a high level of social security, relatively small income differences and easy access to medical care for all its inhabitants. Other risk factors that were taken into account were smoking, drinking, occupation, age and height. Information was collected by interview in the first 3 weeks of life of the mothers of 2027 (response 97%) live-born singletons born in the period from April 1988 to October 1989 in the study area. After adjustment for possible confounding factors very low social class, compared with high social class, was significantly associated with reduced birthweight (-4.0%; 95% CI, -7.4% to -0.7%), but not with preterm delivery (OR, 2.09; 95% CI, 0.67-6.48). The adjusted birthweight of Turkish infants (2.7%; 95% CI, -1.1% to 6.5%) and the adjusted birthweight of infants from Suriname or the Antilles (-1.6%; 95% CI, -5.5% to 2.1%) were not significantly different compared with infants of Dutch mothers. After adjustment, the frequency of preterm birth was lower in Turkish infants, but not significantly (OR, 0.22; 95% CI, 0.04-1.10), whereas the frequency of preterm birth in infants from Suriname or the Antilles was significantly higher (OR, 2.51; 95% CI, 1.04-6.08) compared with Dutch infants. Of the other factors the main risk factors were smoking (negatively related with birth-weight) and maternal age(ABSTRACT TRUNCATED AT 250 WORDS)
Verkerk
P H
PH
TNO Institute for Preventive Health Care, Department of Social Pediatrics and Child Health, Leiden, The Netherlands.
Zaadstra
B M
BM
Reerink
J D
JD
Herngreen
W P
WP
Verloove-Vanhorick
S P
SP
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005006:Ethnicity; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D009426:Netherlands; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012923:Social Class; D013532:Suriname / Q000208:ethnology; D014421:Turkey / Q000208:ethnology; D014900:West Indies / Q000208:ethnology