The influence of maternal childhood and adulthood social class on the health of the infant.
The aim of this study is to investigate how maternal childhood and adulthood social class contribute to social inequalities in low birth weight, neonatal mortality and postneonatal mortality. In particular I consider the combined influence of childhood and adult class, and compare outcomes with regard to the time distance from birth. Analyses were performed on a large sample of Swedish births from 1973 to 1990, restricted to infants of women with both childhood and adult class, classified as manual or non-manual. Logistic regression is used to compare odds ratios for social classes. The results indicate that manual maternal childhood class is consistently associated with higher risks for low birth weight and neonatal mortality, even when adult class was adjusted for. The influence of adult class was greater than that of childhood class for all health outcomes. Compared to higher/middle non-manual workers, unskilled workers in the service sector and workers in the manufacturing sector displayed the highest odds ratios for all adverse health outcomes. When both childhood and adult class were taken into account, social differences were greater for low birth weight and neonatal mortality than for postneonatal mortality. Maternal childhood class had more influence on low birth weight and neonatal mortality than on postneonatal mortality. I conclude that maternal childhood and adulthood social class are both independently associated with inequalities in health-related birth outcomes, and that social differences are greater for health outcomes closer to birth.
Gisselmann
Marit Dahlén
MD
Centre for Health Equity Studies-CHESS, Stockholms Universitet/Karolinska Institutet, Stockholm 106 91, Sweden. marit.gisselmann@chess.su.se
D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D009035:Mothers; D012044:Regression Analysis; D012307:Risk Factors; D012923:Social Class; D012937:Social Mobility; D013548:Sweden / Q000453:epidemiology