Social class inequalities in perinatal outcomes: Scotland 1980-2000.
OBJECTIVE
To examine social class inequalities in adverse perinatal events in Scotland between 1980 and 2000 and how these were influenced by other maternal risk factors.


METHODS
Population based study using routine maternity discharge data.


METHODS
Scotland.


METHODS
All women who gave birth to a live singleton baby in Scottish hospitals between 1980 and 2000 (n=1,282,172).


METHODS
Low birth weight (LBW), preterm birth, and small for gestational age (SGA).


RESULTS
The distribution of social class changed over time, with the proportion of mothers with undetermined social class increasing from 3.9% in 1980-84 to 14.8% in 1995-2000. The relative index of inequality (RII) decreased during the 1980s for all outcomes. The RII then increased between the early and late 1990s (LBW from 2.09 (95%CI 1.97, 2.22) to 2.43 (2.29, 2.58), preterm from 1.52 (1.44, 1.61) to 1.75 (1.65, 1.86), and SGA from 2.28 (2.14, 2.42) to 2.49 (2.34, 2.66) respectively). Inequalities were greatest in married mothers, mothers aged over 35, mothers taller than 164 cm, and mothers with a parity of one or more. Inequalities were also greater by the end of the 1990s than at the start of the 1980s for women of parity one or more and for mothers who were not married.


CONCLUSIONS
Despite decreasing during the 1980s, inequalities in adverse perinatal outcomes increased during the 1990s in all strata defined by maternal characteristics.
Fairley
L
L
MRC Social and Public Health Sciences Unit, University of Glasgow, 4 Lilybank Gardens, Glasgow G12 8RZ, UK. L.Fairley@msoc.mrc.ac.uk
Leyland
A H
AH
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D047928:Premature Birth / Q000453:epidemiology*; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012923:Social Class