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Published on: March 10, 2020
[Socioeconomic status and risk of congenital malformations]
Aldo Rosano1, Elisabetta Del Bufalo, Alessandra Burgio
1Istituto Italiano di Medicina Sociale, Roma. rosano@asplazio.it
Insights
Low socioeconomic status is linked to increased risks of neural tube defects (NTD) and orofacial clefts (OFC) at birth. Maternal education is a significant factor for OFC, highlighting social inequalities in reproductive health.
Area of Science:
- Reproductive Health
- Pediatric Epidemiology
- Public Health
Context:
- Congenital malformations (CMs) represent a significant global health concern.
- Socioeconomic disparities are increasingly recognized as influencing health outcomes, including birth defects.
- Understanding the interplay between socioeconomic factors and specific CMs is crucial for targeted prevention strategies.
Purpose:
- To investigate the association between parental socioeconomic status and the prevalence of neural tube defects (NTD), orofacial clefts (OFC), and Down syndrome (DS) at birth.
- To identify specific socioeconomic indicators, such as education and employment, that may act as risk factors for these congenital malformations.
- To analyze data from a large cohort of births across multiple Italian regions.
Summary:
- A matched case-control study analyzed 485 children with selected congenital malformations against a control group.
- Results indicated a higher risk of NTD and OFC in offspring of parents from lower social classes.
- Maternal education level emerged as a significant risk factor specifically for OFC occurrence.
Impact:
- The findings underscore the role of socioeconomic status as a potential selective risk factor for specific congenital malformations.
- This research confirms the impact of social inequalities on reproductive health.
- The results provide evidence for developing targeted public health interventions to prevent congenital malformations, particularly in vulnerable populations.
Objective:
to analyse the relationship between socioeconomic factors and the prevalence at birth of a selected group of congenital malformations (CM): neural tube defects (NTD), orofacial clefts (OFC), Down syndrome (DS).
Design:
matched case-control study. The aim of the study was to compare the parental socioeconomic status of 485 children affected by one of the selected congenital malformations with an appropriate control group, using both a synthetic index, as well as comparing each socioeconomic characteristic. Socioeconomic measures included maternal and paternal education and employment.
Setting:
Delivery certificate database from 18 Italian regions, years 2002-2003.
Main Outcome Measures:
odds ratio (OR) measuring the association between the presence at birth of specific CMs and socioeconomic factors, estimated through logistic regression models.
Results:
the study showed a higher risk for NTD (OR 2.73; 95% CI 1.36-5.50) and OFC (OR 1.18; 95% CI 1.05-1.33)for parents in a low social class. As well, the estimated risk of DS is slightly higher, though not statistically significant (OR 1.08; 95% CI 0.98-1.19). Among the socioeconomic variables taken into consideration, the mother's education level represented a significant risk factor associated with OFC occurrence.
Conclusion:
the results suggested that the socioeconomic level may represent a selective risk factor for specific CMs, confirming the role that social inequalities have on health, in particular on reproductive health. Such evidences should be considered when programming specific actions aimed at preventing congenital malformations.
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