Document Detail

Living in deprived urban districts increases perinatal health inequalities.
MedLine Citation:
PMID:  23039164     Owner:  NLM     Status:  Publisher    
Abstract Objective: Analyses of the effects of place of residence, socio-economic status and ethnicity on perinatal mortality and morbidity in the Netherlands. Methods: Epidemiological analysis of all singleton deliveries ≥ 22 gestational weeks (871 889 live born and 5927 stillborn) from the Dutch National Perinatal Registry 2002-2006. Multiple logistic regression analysis was used to determine whether place of residence (deprived neighbourhood, or not) contributed to the adverse perinatal outcome (defined as perinatal mortality, preterm birth, small for gestational age, congenital abnormalities or Apgar score < 7, 5 minutes after birth), additional to individual pregnancy characteristics, demographic characteristics, ethnic background and socio-economic class. Results: Incidence of adverse perinatal outcome was 16.7 %. After adjustment the excess risk for perinatal mortality in deprived districts was 21%, for preterm birth 16%, for small-for-gestational age 11%, and for Apgar score < 7 after 5 minutes 11%. Conclusions: Perinatal inequalities appear impressive in both urban and non-urban areas, with a significant additive risk of living in a deprived neighbourhood. Excess risk for perinatal mortality generally outranges that for morbidity, suggesting both an etiological and prognostic pathway for neighbourhood effects. A distinct pattern exists for congenital anomalies, for which first trimester adverse selection effects may be responsible.
Johanna P de Graaf; Anita C J Ravelli; Marij A M de Haan; Eric A P Steegers; Gouke J Bonsel
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-8
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  -     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, P.O. Box 2040, 3000 CA, The Netherlands.
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