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- Title
Variation in Maternal Co-morbidities and Obstetric Interventions across Area-Level Socio-economic Status: A Cross-Sectional Study.
- Authors
Adhikari Dahal, Kamala; Premji, Shahirose; Patel, Alka B.; Williamson, Tyler; Peng, Mingkai; Metcalfe, Amy
- Abstract
<bold>Background: </bold>Multiple studies indicate a significant association between area-level socio-economic status (SES) and adverse maternal health outcomes; however, the impact of area-level SES on maternal co-morbidities and obstetric interventions has not been examined.<bold>Objective: </bold>To examine the variation in maternal co-morbidities and obstetric interventions across area-level SES.<bold>Methods: </bold>This study used data from the Discharge Abstract Database that comprised birth data in Alberta between 2005-2007 (n = 120 285). Co-morbidities and obstetric interventions were identified using validated case-definitions. Material deprivation index was obtained for each dissemination area through linkage of hospitalisation and census data. Multilevel logistic regression was used to analyse the data adjusting for potential confounding variables.<bold>Results: </bold>The prevalence of any co-morbidity varied across area-level SES. Drug abuse odds ratio (OR) 2.5 (95% confidence interval (CI) 1.8, 3.5), pre-existing diabetes OR 1.7 (95% CI 1.1, 2.6), and prolonged hospital stay OR 1.5 (95% CI 1.4, 1.6) were significantly more likely to occur in the most deprived areas compared to the least deprived areas. In contrast, caesarean delivery OR 0.9 (95% CI 0.8, 0.9) was less likely to occur in the most deprived areas compared to the least deprived areas. Area-level deprivation explained area-level variance of drug abuse, HIV, and other mental diseases only.<bold>Conclusion: </bold>Many co-morbidities and obstetric interventions vary at the area-level, but only some are associated with area-level SES, and few of them vary due to the area-level SES. This indicates that other area-level factors, in addition to area-level SES, need to be considered when investigating maternal health and use of health interventions.
- Subjects
ALBERTA; SOCIAL status; MATERNAL health; OBSTETRICAL practice; HOSPITAL care; HEALTH care intervention (Social services); DIABETES complications; TREATMENT of pregnancy complications; CESAREAN section; LENGTH of stay in hospitals; POVERTY; PREGNANCY complications; SUBSTANCE abuse; LOGISTIC regression analysis; SOCIOECONOMIC factors; DISEASE prevalence; CROSS-sectional method
- Publication
Paediatric & Perinatal Epidemiology, 2017, Vol 31, Issue 4, p274
- ISSN
0269-5022
- Publication type
journal article
- DOI
10.1111/ppe.12370