title: Increasing social variation in birth outcomes in the Czech Republic after 1989.
abstract: OBJECTIVE
  This study investigated social variation in birth outcome in the Czech Republic after the political changes of 1989.
  
  
  METHODS
  Routinely collected records on singleton live births in 1989, 1990, and 1991 (n = 380,633) and 1994, 1995, and 1996 (n = 286,907) were individually linked to death records.
  
  
  RESULTS
  Mean birthweight fell from 3,323 g to 3,292 g (P < .001) between 1989 and 1991 and then increased to 3,353 g by 1996. The gap in mean birthweight between mothers with a primary education and those with a university education, adjusted for age, parity, and sex of infants, widened from 182 g (95% confidence interval [CI] = 169, 19) in 1989 to 256 g (95% CI = 240, 272) in 1996. Similar trends were found for preterm births. Postneonatal mortality declined most among the better educated and the married. The odds ratio for postneonatal death for infants of mothers with a primary (vs university) education, adjusted for birthweight, increased from 1.99 (95% CI = 1.52, 2.60) in 1989 through 1991 to 2.39 (95% CI = 1.55, 3.70) in 1994 through 1995.
  
  
  CONCLUSIONS
  Despite general improvement in the indices of fetal growth and infant survival in the most recent years, social variation in birth outcome in the Czech Republic has increased.
authors.affiliation: European Centre on Health of Societies in Transition, London School of Hygiene and Tropical Medicine, England.
authors.forename: I
authors.initials: I
authors.lastname: Koupilová
authors.forename: M
authors.initials: M
authors.lastname: Bobák
authors.forename: J
authors.initials: J
authors.lastname: Holĉík
authors.forename: H
authors.initials: H
authors.lastname: Pikhart
authors.forename: D A
authors.initials: DA
authors.lastname: Leon
mesh_terms: D000328:Adult; D001724:Birth Weight; D018153:Czech Republic / Q000453:epidemiology; D003625:Data Collection; D004522:Educational Status; D005260:Female; D005298:Fertility; D006801:Humans; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D008297:Male; D017533:Marital Status; D016017:Odds Ratio; D011159:Population Surveillance; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D015203:Reproducibility of Results; D012923:Social Class