The effect of social deprivation on birthweight, excluding physiological and pathological effects.
OBJECTIVE
To study the effect of social deprivation on birthweight, excluding the effect of known physiological factors and exploring the effect of possible pathological factors.


METHODS
Retrospective analysis of computerised obstetric database.


METHODS
Two teaching hospitals and an associated district general hospital which provided a defined catchment area in the East Midlands.


METHODS
The final analysis included 7493 women with complete datasets and gestations of between 259 and 300 days at delivery, dated by ultrasound scan.


METHODS
Smoking habit, alcohol consumption, weight gain during pregnancy, systolic and diastolic blood pressures at booking, bleeding during pregnancy and Jarman score; also, the effect of these variables on birthweight, adjusted for the effects of physiological factors using the individualised birthweight ratio.


RESULTS
Smoking during pregnancy reduced birthweight but the effect is not linear, becoming less marked as the number of cigarettes smoked increases. Alcohol intake, diastolic and systolic blood pressures at the booking visit and vaginal bleeding during early pregnancy were not significantly related to birthweight. Pregnancy weight gain was significantly positively related to birthweight especially in the normal weight range (60-99 kg). A multivariate analysis including physiological and pathological factors found increasing Jarman score to be negatively related to birthweight.


CONCLUSIONS
In this central British population social deprivation is correlated negatively with birthweight: the most socially deprived mothers have the smallest babies. This association cannot be explained in terms of physiological differences in the population nor in a higher prevalence of known pathological factors.
Wilcox
M A
MA
Department of Obstetrics and Gynaecology, University of Nottingham, UK.
Smith
S J
SJ
Johnson
I R
IR
Maynard
P V
PV
Chilvers
C E
CE
D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D001724:Birth Weight; D001794:Blood Pressure; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D012923:Social Class; D012934:Social Isolation; D015430:Weight Gain