Socio-demographic determinants of poor infant outcome in north-west Russia

The infant outcome determinants vary in different settings, and there is still a need for analysis within environments. This study was designed to examine the relation between poor infant outcome (PIO), (i.e. any of the following indicators: preterm delivery, low birthweight, perinatal death and low first-minute Apgar score) and socio-demographic factors, smoking and alcohol consumption in a Russian setting. The study was conducted in the town of Severodvinsk, north-west Russia. A total of 1404 pregnant women who attended antenatal care clinics in 1999 and delivered at the municipal maternity home comprised the cohort. Data on women and infants were collected from the medical files and a questionnaire on social indicators, smoking and alcohol consumption was administered. The adjusted odds ratio (OR) calculated by multivariable logistic regression was used as the measure of association between PIO and the variables studied. Education was found to be the most significant factor associated with PIO (OR = 1.9, 95% CI 1.2, 3.0 for secondary or less education compared with at least 3 years of university studies). Increased risks of PIO were also found in mothers aged 30 years and older (OR = 1.6, 95% CI 1.1, 2.5 compared with other age groups) and in unmarried mothers (OR = 1.4, 95% CI 1.0, 1.9) after control for the possible confounders. Other socio-demographic determinants studied (smoking, alcohol use, stress, maternal occupation, housing and young age of the mother) could not be found to influence PIO. The findings contribute to the hypothesis that maternal education is one of the most important social factors influencing pregnancy outcomes in countries in transition.