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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

Low birth weight versus social class.
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fig3: Low birth weight versus social class.

Mentions: Five studies262730–32 measured deprivation at an individual level using the Registrar General's social class categories. All but Maher and Macfarlane32 compared social class V with social class I; Maher and Macfarlane compared manual and non-manual workers, and this is probably a less extreme comparison, leading to a smaller OR. For social class, as opposed to area deprivation, Dibben et al26 only reported a heavily adjusted OR of 1.20 and thus was not included in the meta-analysis. The unadjusted estimates of the OR varied from 1.45 to 2.17. Excluding Dibben et al,26 a random effects model pooling these gave an overall estimate of 1.79 (95% CI 1.43 to 2.24), very similar to the estimate for the area-based measures (figure 3).


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)

Low birth weight versus social class.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Low birth weight versus social class.
Mentions: Five studies262730–32 measured deprivation at an individual level using the Registrar General's social class categories. All but Maher and Macfarlane32 compared social class V with social class I; Maher and Macfarlane compared manual and non-manual workers, and this is probably a less extreme comparison, leading to a smaller OR. For social class, as opposed to area deprivation, Dibben et al26 only reported a heavily adjusted OR of 1.20 and thus was not included in the meta-analysis. The unadjusted estimates of the OR varied from 1.45 to 2.17. Excluding Dibben et al,26 a random effects model pooling these gave an overall estimate of 1.79 (95% CI 1.43 to 2.24), very similar to the estimate for the area-based measures (figure 3).

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