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Social inequality and infant health in the UK: systematic review and meta-analyses.

Weightman AL, Morgan HE, Shepherd MA, Kitcher H, Roberts C, Dunstan FD - BMJ Open (2012)

Bottom Line: This review quantifies the influence of social disadvantage on infant outcomes in the UK.The magnitude of effect is similar across a range of area and individual deprivation measures and birth and mortality outcomes.Further research should explore the factors that are more proximal to mothers and infants, to help throw light on the most appropriate times to provide support and the form(s) that this support should take.

View Article: PubMed Central - PubMed

Affiliation: Support Unit for Research Evidence (SURE), Information Services, Cardiff University, Cardiff, UK.

ABSTRACT

Objectives: To determine the association between area and individual measures of social disadvantage and infant health in the UK.

Design: Systematic review and meta-analyses.

Data sources: 26 databases and websites, reference lists, experts in the field and hand-searching.

Study selection: 36 prospective and retrospective observational studies with socioeconomic data and health outcomes for infants in the UK, published from 1994 to May 2011.

Data extraction and synthesis: 2 independent reviewers assessed the methodological quality of the studies and abstracted data. Where possible, study outcomes were reported as ORs for the highest versus the lowest deprivation quintile.

Results: In relation to the highest versus lowest area deprivation quintiles, the odds of adverse birth outcomes were 1.81 (95% CI 1.71 to 1.92) for low birth weight, 1.67 (95% CI 1.42 to 1.96) for premature birth and 1.54 (95% CI 1.39 to 1.72) for stillbirth. For infant mortality rates, the ORs were 1.72 (95% CI 1.37 to 2.15) overall, 1.61 (95% CI 1.08 to 2.39) for neonatal and 2.31 (95% CI 2.03 to 2.64) for post-neonatal mortality. For lowest versus highest social class, the odds were 1.79 (95% CI 1.43 to 2.24) for low birth weight, 1.52 (95% CI 1.44 to 1.61) for overall infant mortality, 1.42 (95% CI 1.33 to1.51) for neonatal and 1.69 (95% CI 1.53 to 1.87) for post-neonatal mortality. There are similar patterns for other infant health outcomes with the possible exception of failure to thrive, where there is no clear association.

Conclusions: This review quantifies the influence of social disadvantage on infant outcomes in the UK. The magnitude of effect is similar across a range of area and individual deprivation measures and birth and mortality outcomes. Further research should explore the factors that are more proximal to mothers and infants, to help throw light on the most appropriate times to provide support and the form(s) that this support should take.

No MeSH data available.


Related in: MedlinePlus

Postneonatal mortality versus social class.
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fig10: Postneonatal mortality versus social class.

Mentions: Comparing social class, Dummer and Parker36 found an OR of 2.24 (95% CI 0.81 to 6.23) and Petrou et al40 recorded 1.70 (95% CI 1.14 to 2.54) comparing classes V and I. Whitehead and Drever38 found an OR of 1.69 (95% CI 1.52 to 1.88) for comparing classes IV and V with I and II. Oakley et al37 used the newer NS_SEC classification19 and compared Higher and Professional with Routine and manual, finding an OR of 2.63 (95% CI 1.41 to 1.91). The pooled OR was 1.69 (95% CI 1.53 to 1.87) (figure 10). Petrou et al40 and Oakley et al37 adjusted for a number of factors, leading to reductions in the estimated ORs as shown in online appendix 1.


Social inequality and infant health in the UK: systematic review and meta-analyses.

Weightman AL, Morgan HE, Shepherd MA, Kitcher H, Roberts C, Dunstan FD - BMJ Open (2012)

Postneonatal mortality versus social class.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3378945&req=5

fig10: Postneonatal mortality versus social class.
Mentions: Comparing social class, Dummer and Parker36 found an OR of 2.24 (95% CI 0.81 to 6.23) and Petrou et al40 recorded 1.70 (95% CI 1.14 to 2.54) comparing classes V and I. Whitehead and Drever38 found an OR of 1.69 (95% CI 1.52 to 1.88) for comparing classes IV and V with I and II. Oakley et al37 used the newer NS_SEC classification19 and compared Higher and Professional with Routine and manual, finding an OR of 2.63 (95% CI 1.41 to 1.91). The pooled OR was 1.69 (95% CI 1.53 to 1.87) (figure 10). Petrou et al40 and Oakley et al37 adjusted for a number of factors, leading to reductions in the estimated ORs as shown in online appendix 1.

Bottom Line: This review quantifies the influence of social disadvantage on infant outcomes in the UK.The magnitude of effect is similar across a range of area and individual deprivation measures and birth and mortality outcomes.Further research should explore the factors that are more proximal to mothers and infants, to help throw light on the most appropriate times to provide support and the form(s) that this support should take.

View Article: PubMed Central - PubMed

Affiliation: Support Unit for Research Evidence (SURE), Information Services, Cardiff University, Cardiff, UK.

ABSTRACT

Objectives: To determine the association between area and individual measures of social disadvantage and infant health in the UK.

Design: Systematic review and meta-analyses.

Data sources: 26 databases and websites, reference lists, experts in the field and hand-searching.

Study selection: 36 prospective and retrospective observational studies with socioeconomic data and health outcomes for infants in the UK, published from 1994 to May 2011.

Data extraction and synthesis: 2 independent reviewers assessed the methodological quality of the studies and abstracted data. Where possible, study outcomes were reported as ORs for the highest versus the lowest deprivation quintile.

Results: In relation to the highest versus lowest area deprivation quintiles, the odds of adverse birth outcomes were 1.81 (95% CI 1.71 to 1.92) for low birth weight, 1.67 (95% CI 1.42 to 1.96) for premature birth and 1.54 (95% CI 1.39 to 1.72) for stillbirth. For infant mortality rates, the ORs were 1.72 (95% CI 1.37 to 2.15) overall, 1.61 (95% CI 1.08 to 2.39) for neonatal and 2.31 (95% CI 2.03 to 2.64) for post-neonatal mortality. For lowest versus highest social class, the odds were 1.79 (95% CI 1.43 to 2.24) for low birth weight, 1.52 (95% CI 1.44 to 1.61) for overall infant mortality, 1.42 (95% CI 1.33 to1.51) for neonatal and 1.69 (95% CI 1.53 to 1.87) for post-neonatal mortality. There are similar patterns for other infant health outcomes with the possible exception of failure to thrive, where there is no clear association.

Conclusions: This review quantifies the influence of social disadvantage on infant outcomes in the UK. The magnitude of effect is similar across a range of area and individual deprivation measures and birth and mortality outcomes. Further research should explore the factors that are more proximal to mothers and infants, to help throw light on the most appropriate times to provide support and the form(s) that this support should take.

No MeSH data available.


Related in: MedlinePlus