The Impact of Social Determinants on Perinatal Outcome

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

Abstract


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.


Keywords


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

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References


K.M. Godfrey and D.J. Barker. “Fetal programming and adult health”. Public Health Nutr.

(2B), 611-624, 2001

P. D. Wadhwa. “Psychoneuroendocrine processes in human pregnancy influence fetal development and health”. Psychoneuroendocrinology, 30(8), 724-743, 2005.

P. D. Gluckman, M. A. Hanson, C. Cooper, andK. L. Thornburg. “Effect of In Utero and Early-Life

Conditions on Adult Health and Disease”. New England Journal of Medicine; 359(1), 61-73, 2008

American Academy for Pediatrics. American College for Obstetrics and Gynecology. Guidelines for perinatal care.2012; 7th Edition, ISBN 978-1-58110-734-0 (AAP)—ISBN 978-1-934984-17-8 (ACOG) American Academy of Pediatrics. II. American College of Obstetricians. US 2012

World Health Organization. Web site: http://www.who.int/maternal_child_adolescent/topics/maternal/maternal_perinatal/en/. Accessed 15.05.2018

D. P. Misra, B. Guyer, and A. Allston. “Integrated perinatal health framework. A multiple determinants model with a life span approach”. American Journal of Preventive Medicine; 25(1), 2003

World Health Statistics, 2017: Monitoring health for the SDGs, Sustainable Development Goals ISBN 978-92-4-156548-6. World Health Organization

UNDP, 2011. A Social Determinants Approach to Maternal Health: Roles for Development Actors, Discussion Paper. Bureau for Development Policy.19 October 2011.

D. Spiegelman and E. Hertzmark E. “Easy SAS calculations for risk or prevalence ratios and differences.” Am J Epidemiol, 162:199–200, 2005

M. H. Aliyu, S. Luke, RE Wilson, R. Saidu, AP Alio, HM Salihu, and V. Belogolovkin. “Obesity in older

mothers, gestational weight gain, and risk estimates for preterm phenotypes”. Maturitas. 66(1): 88-93 Epub 2010, Mar 21, 2010

ZA Bhutta, ZS Lassi, A. Blanc and F. Donnay F. “Linkages among reproductive health, maternal health, and perinatal outcomes”. Semin Perinatol. 2;34(6):434-45, 2010 doi: 10.1053/j.semperi.2010.09.002.

A. Kadir, F.Marais, N. Desmond. “Community Perceptions of the Social Determinants of

Child Health in Western Cape, South Africa: Neglect as a Major Predictor of Child Health and Wellness”.Paediatrics and International Child Health. Vol 33:4, 310-321, 2013.

ML Nordstrom, S. Cnattingius S. :Effects on birth weights of maternal education, socioeconomic status, and work related characteristics”. Scand J Public Health, 24(1):55–61, 1996

A. Antonovsky and J. Bernstein J. “Social class and infant mortality”. Soc Sci Med, 11(8-9):453–70, 1997

A. Cantarutti, M. Franchi, MM Compagnoni, L. Merlino and G. Corrao G. “Mother's education and the risk of several neonatal outcomes: An evidence from an Italian population-based study. BMC Pregnancy and Childbirth; 17(1):221, 2017

HG Dunn. “Social aspects of low birth weight, 1984”. Can Med Assoc J,130(9):1131–40. 1984

M. Joffre M. “Social inequalities in low birth weight: Timing of effects and selective mobility”. Soc Sci Med, 28(6):613–19, 1989.

M. Nair, P.Webster, and P. Ariana. “Impact of non-health policies on infant mortality through the social determinants pathway”. Bull. WHO, 89, 778. 2011 doi: 10.2471/BLT.11.093799.

ZA Bhutta, S. Cabral, C.W. Chan, and W.J. Keenan. “Reducing Maternal, Newborn, and Infant

Mortality Globally: An Integrated Action Agenda.” International Journal of Gynecology and Obstetrics; 119(Suppl 1): S13-17, 2012

RE Behrman and AS Butler (Editors). Preterm Birth. Causes, Consequences, and Prevention. Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes, 2007. Washington (DC): National Academies Press (US). ISBN-13: 978-0-309-10159-2ISBN-10: 0-309-10159-X

ME Wallace, EW Harville. “Predictors of healthy birth outcome in adolescents: a positive deviance approach”. J Pediatr Adolesc Gynecol. 25(5):314-21, 2012 doi: 10.1016/j.jpag.2012.05.010. Epub 2012 Jul 24.

L. Dubowitz, D. Ricciw, E. Mercuri E. “The Dubowitz neurological examination of the full-term newborn.” Ment Retard Dev Disabil Res Rev. 11:52, 2005.

AC Lee, P. Panchal, L. Folger L et al. “Diagnostic Accuracy of Neonatal Assessment for Gestational Age Determination: A Systematic Review”. Pediatrics; 140 (6), 2017.

DA Savitz, AF Olshan, and K Gallagher. “Maternal Occupation and Pregnancy Outcome”. Epidemiology. Volume 7 - Issue 3 - ppg 269-274, 1996

AA Usynina, AM Grjibovski, JO Odland aand A. Krettek. “Social correlates of term small for gestational age babies in a Russian Arctic setting”. Int J Circumpolar Health. Nov 29;75:32883, 2016 doi: 10.3402/ijch.v75.32883. eCollection 2016.

PWG Tennant, J, Rankin, and R. Bell. “Maternal body mass index and the risk of fetal and infant death: A cohort study from the North of England”. Hum. Reprod. 26, 1501–1511, 2011

Leason JL. “Exploring the complex context of Canadian Indigenous maternal child-health through maternity experiences: The role of social determinants of health.” Social Determinants of Health, Vol.4, No.2, 2018, 54-68, 2018

L. Chen, L. Xiao, N. Auger, et al. “Disparities and Trends in Birth Outcomes, Perinatal and Infant

mortality in Aboriginal vs. Non-Aboriginal Populations: A Population-Based Study in Quebec, Canada 1996–2010.” HEN A, ed. PLoS ONE;10(9):e0138562, 2015

M Saunders, B. Barr B, P. McHale P and C. Hamelmann. “Key policies for addressing the social determinants of health and health inequities.” Copenhagen: WHO Regional Office for Europe; (Health Evidence. Network (HEN) Synthesis Report 52), 2017

S. Egerter, P. Braveman, T. Sadegh-Nobari, R. Grossman-Kahn, and M. Dekker. “Education and Health”. Publisher: Robert Wood Johnson Foundation, 2011

PS Shah, J. Zao, S. Ali S. “Maternal Marital Status and Birth Outcomes: A Systematic Review and Meta-Analyses”. Matern Child Health J. Oct;15(7):1097-109, 2011doi: 10.1007/s10995-010-0654


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