Ethno-Specific Risk Factors for Adverse Pregnancy Outcomes: Findings from the Born in Bradford Cohort Study
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Ethno-Specific Risk Factors for Adverse Pregnancy Outcomes: Findings from the Born in Bradford Cohort Study Tomasina Stacey1 • Stephanie Prady2 • Melanie Haith-Cooper3 • Soo Downe4 Nigel Simpson5 • Kate Pickett2
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Ó The Author(s) 2016. This article is published with open access at Springerlink.com
Abstract Objectives Preterm birth (PTB) and small for gestational age (SGA) are major causes of perinatal mortality and morbidity. Previous studies indicated a range of risk factors associated with these poor outcomes, including maternal psychosocial and economic wellbeing. This paper will explore a range of psycho-social and economic factors in an ethnically diverse population. Methods The UK’s Born in Bradford cohort study recruited pregnant women attending a routine antenatal appointment at 26–28 weeks’ gestation at the Bradford Royal Infirmary (2007–2010).
& Tomasina Stacey [email protected] Stephanie Prady [email protected] Melanie Haith-Cooper [email protected] Soo Downe [email protected] Nigel Simpson [email protected] Kate Pickett [email protected] 1
School of Healthcare, University of Leeds, Leeds LS2 9JT, UK
2
Department of Health Sciences, University of York, Heslington, York, Yorkshire YO10 5DD, UK
3
School of Health Studies, University of Bradford, Richmond Road, Bradford, Yorkshire BD7 1DP, UK
4
School of Health, University of Central Lancashire, Brook Building, Preston PR1 2HE, UK
5
Department of Women’s and Children’s Health, Level 9, University of Leeds, Worsley Building, Clarendon Way, Leeds LS2 9NL, UK
This analysis includes 9680 women with singleton live births who completed the baseline questionnaire. Data regarding maternal socio-demographic and mental health were recorded. Outcome data were collected prospectively, and analysed using multivariate regression models. The primary outcomes measured were: PTB (\37 weeks’ gestation) and SGA (\10th customised centile). Results After adjustment for socio-demographic and medical factors, financial strain was associated with a 45 % increase in PTB (OR 1.45: 95 % CI 1.06–1.98). Contrary to expectation, maternal distress in Pakistani women was negatively associated with SGA (OR 0.65: CI 0.48–0.88). Obesity in White British women was protective for PTB (OR 0.67: CI 0.45–0.98). Previously recognized risk factors, such as smoking in pregnancy and hypertension, were confirmed. Conclusions This study confirms known risk factors for PTB and SGA, along with a new variable of interest, financial strain. It also reveals a difference in the risk factors between ethnicities. In order to develop appropriate targeted preventative strategies to improve perinatal outcome in disadvantaged groups, a greater understanding of ethno-specific risk factors is required. Keywords Small for gestational age Preterm birth Born in Bradford Depression Financial strain Ethnic differences
Significance What is Already Known on this Topic? A number of risk factors have been identified for small for gestational age and preterm birth. The
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