The Impact of Social Determinants on Perinatal Outcome

Elizabeta Zisovska, Goce Kalcev, Dritan Dauti, Simon Besliev, Visna Gacova, Katerina Dzateva


The health of the pregnant woman has high impact over the health of her offspring. The social determinants of health are the circumstances in which people are born, grow, live, work and age.  Aim: to evaluate the impact of few pre-pregnancy and social determinants on overall conceptual model of perinatal health. Material and methods: prospective cohort study evaluating preterm, SGA and LBW newborns in relation to social determinants in pregnant women at University Clinic for Gynecology and Obstetrics-Skopje. Results: the Relative Risk (RR) for delivering preterm baby (35-37 g.w. in unemployed mother is 2,96 with significant Confidence Interval, (1,86-4,71). If four more mothers are employed, there is a chance to get one preterm baby less, which means that this intervention could be beneficial for both. The Relative risk of delivering SGA baby in unemployed mothers is 1,98. The Relative risk to get preterm baby if BMI < 18 is 3,08 and is much higher than getting SGA baby (RR=1,85). The RR for delivering preterm baby and SGA baby at mothers with BMI >25 is 2,96 and 1,44 respectively. On the other hand, the RR for the both outcomes has no statistical significance independently whether the mother is living in rural or urban areas. Discussion and Conclusion: there is different impact of the social determinants on the perinatal outcome, and varying extent, depending on the country, social security, economic development. Many complementary actions should be undertaken by the Government, because the social determinants tackle every cell of the society.


social determinant; newborn; perinatal; health; preterm baby; birth weight.

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