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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

Stillbirth versus area deprivation.
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fig6: Stillbirth versus area deprivation.

Mentions: For stillbirths, there were four studies (Paranjothy, 2010, unpublished)294748 all of which postdate the change in definition resulting from the Still-Birth (Definition) Act of 1992; when births from 24-week gestation were included, the data by Guildea et al47 were subsumed by that of Paranjothy. Published data from Guildea et al47 are, however, included in the Evidence Table (online appendix 1). Gray et al,29 using data from Scotland from 1994 to 2003, found an OR of 1.56 (95% CI 1.38 to 1.77) comparing extreme quintiles based on Carstairs scores calculated for postcode sectors. Paranjothy (2010, unpublished) found a very similar OR of 1.54 (95% CI 1.32 to 1.80) comparing extreme quintiles of the Townsend score calculated for lower super output areas. Combining these two studies (Paranjothy, 2010, unpublished),29 a pooled estimate of the OR is 1.54 (95% CI 1.39 to 1.72) (figure 6).


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)

Stillbirth versus area deprivation.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig6: Stillbirth versus area deprivation.
Mentions: For stillbirths, there were four studies (Paranjothy, 2010, unpublished)294748 all of which postdate the change in definition resulting from the Still-Birth (Definition) Act of 1992; when births from 24-week gestation were included, the data by Guildea et al47 were subsumed by that of Paranjothy. Published data from Guildea et al47 are, however, included in the Evidence Table (online appendix 1). Gray et al,29 using data from Scotland from 1994 to 2003, found an OR of 1.56 (95% CI 1.38 to 1.77) comparing extreme quintiles based on Carstairs scores calculated for postcode sectors. Paranjothy (2010, unpublished) found a very similar OR of 1.54 (95% CI 1.32 to 1.80) comparing extreme quintiles of the Townsend score calculated for lower super output areas. Combining these two studies (Paranjothy, 2010, unpublished),29 a pooled estimate of the OR is 1.54 (95% CI 1.39 to 1.72) (figure 6).

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