title: Is the economic crisis affecting birth outcome in Spain? Evaluation of temporal trend in underweight at birth (2003-2012).
abstract: BACKGROUND
  There is growing evidence of the impact of the current European economic crisis on health. In Spain, since 2008, there have been increasing levels of impoverishment and inequality, and important cuts in social services.
  
  
  OBJECTIVE
  The objective is to evaluate the impact of the economic crisis on underweight at birth in Spain.
  
  
  METHODS
  Trends in underweight at birth were examined between 2003 and 2012. Underweight at birth is defined as a singleton, term neonatal weight lesser than -2 SD from the median weight at birth for each sex estimated by the WHO Standard Growth Reference. Using data from the Statistical Bulletin of Childbirth, 2 933 485 live births born to Spanish mothers have been analysed. Descriptive analysis, seasonal decomposition analysis and crude and adjusted logistic regression including individual maternal and foetal variables as well as exogenous economic indicators have been performed.
  
  
  CONCLUSIONS
  Results demonstrate a significant increase in the prevalence of underweight at birth from 2008. All maternal-foetal categories were affected, including those showing the lowest prevalence before the crisis. In the full adjusted logistic regression, year-on-year GDP per capita remains predictive on underweight at birth risk. Previous trends in maternal socio-demographic profiles and a direct impact of the crisis are discussed to explain the trends described.
authors.affiliation: a Department of Biology, Faculty of Sciences , c/Darwin, 2, Madrid Autonomous University , Madrid , Spain .
authors.forename: Carlos
authors.initials: C
authors.lastname: Varea
authors.affiliation: a Department of Biology, Faculty of Sciences , c/Darwin, 2, Madrid Autonomous University , Madrid , Spain .
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Terán
authors.affiliation: a Department of Biology, Faculty of Sciences , c/Darwin, 2, Madrid Autonomous University , Madrid , Spain .
authors.forename: Cristina
authors.initials: C
authors.lastname: Bernis
authors.affiliation: b School of Sport, Exercise and Health Sciences, Loughborough University , Loughborough , Leicestershire , UK , and.
authors.forename: Barry
authors.initials: B
authors.lastname: Bogin
authors.affiliation: c Department of Obstetrics and Gynecology, Faculty of Medicine , c/ Arzobispo Morcillo, 4, Madrid Autonomous University , Madrid , Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: González-González
mesh_terms: D057172:Economic Recession; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D013851:Thinness / Q000453:epidemiology* / Q000209:etiology
keywords: Foetal development; birth outcome; maternal stress; socioeconomic disparities; weight at birth