title: Movin' on Up: Socioeconomic Mobility and the Risk of Delivering a Small-for-Gestational Age Infant.
abstract: OBJECTIVE
  Poor fetal growth is associated with increased rates of adverse health outcomes in children and adults. The social determinants of poor fetal growth are not well understood. Using multiple socioeconomic indicators measured at the individual level, this study examined changes in maternal socioeconomic position (SEP) from childhood to adulthood (socioeconomic mobility) in relation to poor fetal growth in offspring.
  
  
  METHODS
  Data were from the Pregnancy Outcomes and Community Health Study (September 1998-June 2004) that enrolled women in mid-pregnancy from 52 clinics in five Michigan communities (2463 women: 1824 non-Hispanic White, 639 non-Hispanic Black). Fetal growth was defined by birthweight-for-gestational age percentiles; infants with birthweight-for-gestational age <10th percentile were referred to as small-for-gestational age (SGA). In logistic regression models, mothers whose SEP changed from childhood to adulthood were compared to two reference groups, the socioeconomic group they left and the group they joined.
  
  
  RESULTS
  Approximately, 8.2 % of women (non-Hispanic White: 6.3 %, non-Hispanic Black: 13.9 %) delivered an SGA infant. Upward mobility was associated with decreased risk of delivering an SGA infant. Overall, the SGA adjusted-odds ratio was 0.34 [95 % confidence interval (CI) 0.17-0.69] for women who moved from lower to middle/upper versus static lower class, and 0.44 (CI 0.28-1.04) for women who moved from middle to upper versus static middle class. There were no significant differences in SGA risk when women were compared to the SEP group they joined.
  
  
  CONCLUSIONS
  Our findings support a link between mother's socioeconomic mobility and SGA offspring. Policies that allow for the redistribution or reinvestment of resources may reduce disparities in rates of SGA births.
authors.affiliation: College of Nursing and Health Professions, Drexel University, 245 N 15th St, Mailstop 501, Philadelphia, PA, 19102, USA. jslaughts@gmail.com.
authors.forename: Jaime C
authors.initials: JC
authors.lastname: Slaughter-Acey
authors.affiliation: Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Fee Road Room B601, East Lansing, MI, 48824, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Holzman
authors.affiliation: Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Fee Road Room B601, East Lansing, MI, 48824, USA.
authors.forename: Danuelle
authors.initials: D
authors.lastname: Calloway
authors.affiliation: Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Fee Road Room B601, East Lansing, MI, 48824, USA.
authors.forename: Yan
authors.initials: Y
authors.lastname: Tian
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D005317:Fetal Growth Retardation / Q000208:ethnology*; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D008824:Michigan / Q000453:epidemiology; D009035:Mothers; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D011446:Prospective Studies; D012307:Risk Factors; D064890:Social Determinants of Health; D012937:Social Mobility; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data
keywords: Birthweight; Intergenerational; Life course socioeconomic position; Small-for-gestational age; Social mobility