title: New index of social deprivation during pregnancy: results from a national study in France.
abstract: OBJECTIVE
  To identify precariousness markers in pregnant women that differ from the usual socioeconomic variables.
  
  
  METHODS
  Data were obtained from the National Perinatal Survey, a representative sample of women giving birth in France in 2010. From six indicators of social vulnerability, four were selected by multiple correspondence analysis. The first axis of this analysis was used, characterised by the following contributory variables: receiving RSA (Revenu de Solidarité Active) allowance; benefitting from the CMU (Couverture Maladie Universelle) system (French social security) or not being insured; not living in own accommodation; and not living with a partner. These four variables were summed to create a deprivation index.
  
  
  RESULTS
  This index was strongly associated with social maternal characteristics and correctly identified women who were socially vulnerable. Furthermore, it was highly related to the psychosocial context, access to care, behaviours during pregnancy, and pregnancy outcomes. These associations remained significant after adjustment for social variables: compared with no deprivation (no factors), a high level of deprivation (≥3 factors) was associated with late prenatal care (OR 5.8, 95% CI 4.6 to 7.2) and small for gestational age (OR 1.5, 95% CI 1.1 to 1.9).
  
  
  CONCLUSIONS
  This index of social deprivation was associated with health issues and behaviours during pregnancy, even after adjustment for social variables, revealing a dimension not measured by the usual variables. Moreover, it is simple to use and easily reproducible.
authors.affiliation: INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Opatowski
authors.affiliation: INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Blondel
authors.affiliation: INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Babak
authors.initials: B
authors.lastname: Khoshnood
authors.affiliation: INSERM UMR 1153- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.
authors.forename: Marie-Josèphe
authors.initials: MJ
authors.lastname: Saurel-Cubizolles
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D011203:Poverty; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D037841:Pregnant People / Q000523:psychology*; D011610:Psychosocial Deprivation; D035862:Vulnerable Populations / Q000523:psychology*; D055815:Young Adult
keywords: Pregnancy; deprivation; social inequalities