title: Housing conditions, perceived stress, smoking, and alcohol: determinants of fetal growth in Northwest Russia.
abstract: BACKGROUND
  Social determinants of health have become important in countries of the former Soviet Union during the time of transition.
  
  
  OBJECTIVE
  This article estimates the influence of living conditions, smoking, alcohol, and maternal stress on fetal growth indices in an urban Russian setting.
  
  
  METHODS
  All pregnant women registered at antenatal care centres in Severodvinsk (Northwest Russia) and their infants comprised the study base (n = 1399). Multivariate linear regression analysis was applied to quantify the effects of the studied factors on birth weight and the ponderal index (PI) adjusted for maternal education, age, occupation, marital status, parity, pre-pregnancy weight, paternal employment, gestational age, and others.
  
  
  RESULTS
  Infants of smoking mothers were 126 g lighter compared with non-smokers [95% confidence interval (CI): -198; -54]. On average, birth weight decreased 27 g per cigarette smoked during pregnancy. Living in shared apartments, living in crowded housing situations, and perceived stress were associated significantly with birth weight loss: -89 g (95% CI: -153; -25), -82 g (95% CI: -136; -28), and -61 g (95% CI: -116; -7), respectively. A positive association between maternal alcohol consumption and birth weight was found. Living with parents was associated positively with both birthweight and PI. Infants whose fathers consumed more than 100 ml of absolute alcohol per week were thinner at birth compared with those of non-drinking and moderate drinking fathers.
  
  
  CONCLUSIONS
  Poor housing conditions, maternal stress, smoking, and alcohol consumption are independent determinants of fetal growth in Northwest Russia.
authors.affiliation: Unit for Preventive Nutrition, Department of Biosciences at NOVUM, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Andrej
authors.initials: A
authors.lastname: Grjibovski
authors.forename: Lars Olov
authors.initials: LO
authors.lastname: Bygren
authors.forename: Boo
authors.initials: B
authors.lastname: Svartbo
authors.forename: Per
authors.initials: P
authors.lastname: Magnus
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D001034:Apgar Score; D001724:Birth Weight / Q000502:physiology*; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D047109:Fetal Development / Q000187:drug effects / Q000502:physiology*; D006798:Housing; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D015999:Multivariate Analysis; D011247:Pregnancy; D011256:Pregnancy Outcome; D012044:Regression Analysis; D012426:Russia; D012907:Smoking / Q000009:adverse effects*; D012923:Social Class; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014505:Urban Population