title: Ethno-Specific Risk Factors for Adverse Pregnancy Outcomes: Findings from the Born in Bradford Cohort Study.
abstract: Objectives Preterm birth (PTB) and small for gestational age (SGA) are major causes of perinatal mortality and morbidity. Previous studies indicated a range of risk factors associated with these poor outcomes, including maternal psychosocial and economic wellbeing. This paper will explore a range of psycho-social and economic factors in an ethnically diverse population. Methods The UK's Born in Bradford cohort study recruited pregnant women attending a routine antenatal appointment at 26-28 weeks' gestation at the Bradford Royal Infirmary (2007-2010). This analysis includes 9680 women with singleton live births who completed the baseline questionnaire. Data regarding maternal socio-demographic and mental health were recorded. Outcome data were collected prospectively, and analysed using multivariate regression models. The primary outcomes measured were: PTB (<37 weeks' gestation) and SGA (<10th customised centile). Results After adjustment for socio-demographic and medical factors, financial strain was associated with a 45 % increase in PTB (OR 1.45: 95 % CI 1.06-1.98). Contrary to expectation, maternal distress in Pakistani women was negatively associated with SGA (OR 0.65: CI 0.48-0.88). Obesity in White British women was protective for PTB (OR 0.67: CI 0.45-0.98). Previously recognized risk factors, such as smoking in pregnancy and hypertension, were confirmed. Conclusions This study confirms known risk factors for PTB and SGA, along with a new variable of interest, financial strain. It also reveals a difference in the risk factors between ethnicities. In order to develop appropriate targeted preventative strategies to improve perinatal outcome in disadvantaged groups, a greater understanding of ethno-specific risk factors is required.
authors.affiliation: School of Healthcare, University of Leeds, Leeds, LS2 9JT, UK. t.stacey@leeds.ac.uk.
authors.forename: Tomasina
authors.initials: T
authors.lastname: Stacey
authors.affiliation: Department of Health Sciences, University of York, Heslington, York, Yorkshire, YO10 5DD, UK.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Prady
authors.affiliation: School of Health Studies, University of Bradford, Richmond Road, Bradford, Yorkshire, BD7 1DP, UK.
authors.forename: Melanie
authors.initials: M
authors.lastname: Haith-Cooper
authors.affiliation: School of Health, University of Central Lancashire, Brook Building, Preston, PR1 2HE, UK.
authors.forename: Soo
authors.initials: S
authors.lastname: Downe
authors.affiliation: Department of Women's and Children's Health, Level 9, University of Leeds, Worsley Building, Clarendon Way, Leeds, LS2 9NL, UK.
authors.forename: Nigel
authors.initials: N
authors.lastname: Simpson
authors.affiliation: Department of Health Sciences, University of York, Heslington, York, Yorkshire, YO10 5DD, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Pickett
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007182:Income; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010154:Pakistan / Q000208:ethnology; D011204:Poverty Areas; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D047928:Premature Birth / Q000208:ethnology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000208:ethnology / Q000523:psychology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
keywords: Born in Bradford; Depression; Ethnic differences; Financial strain; Preterm birth; Small for gestational age