Social variations in pregnancy outcomes in Murmansk county-one of the Northernmost European provinces

A M Grjibovski, Усынина Анна Александровна, Постоев Виталий Александрович, O A Kharkova, JØ Odland

European Journal of Public Health, 2020

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DOI 10.1093/eurpub/ckaa165.1042
Data confidence 70 medium
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Abstract

Abstract Background Pregnancy outcomes are widely used indicators of population wellbeing varying both between and within countries. The aim of this study was to assess social variations in preterm births and term small-for-gestation-age (SGA) infants in the Northernmost provinces of Europe - the Murmansk region - using the data from the first Russian population-based birth registry. Methods A registry-based study of 52 806 births in the Murmansk region for a 5-year period was performed. We studied the prevalence and social determinants of moderate-to-late preterm births (MLPTB, 224-258 days of gestation), very preterm births (VPTB, 196-223 days) and extremely preterm births (EPTB, 154-195 days) and term SGA for both weight and length births (SGAWL). Associations between social factors and pregnancy outcomes were studied by multivariable logistic regression. Results The prevalence of PTB was 6.9 with EPTB, VPTB and MLPTB constituting 0.3%, 0.6% and 6.0%, respectively. A total of 4.1% of infants were SGAWL. Women with primary, secondary and vocational education were 1.59 (95%CI:1.22-1.85), 1.33 (95%CI:1.20-1.48), 1.19 (95%CI:1.22-1.85) times more likely to have MLPTB than women with higher education. Corresponding values for VPTB were 1.65 (95%CI:0.88-3.08), 1.41 (95%CI:1.02-1.95) and 1.27 (95%CI:0.92-1.75), respectively. Single and cohabiting women had significantly elevated risk for MLPTB (ORs=1.47 (95%CI:1.30-1.66) and 1.39 (95%CI:1.26-1.44)) and VLPTB (ORs=2.00, 95% CI: 1.42-2.81 and 1.32, 95% CI: 0.97-1.79) compared to married women. Unmarried mothers were more likely to have SGAWL boys (OR = 1.60, 95% CI: 1.38-1.86) and SGAWL girls (OR = 1.51, 95%CI:1.31-1.76) compared to married women. Conclusions We observed significant social variations in pregnancy outcomes by maternal education and marital status in the Murmansk region. Registry data can be used as an effective tool for monitoring inequalities in pregnancy outcomes as indicators of social inequalities. Key messages We found significant social variations in pregnancy outcomes in the Northernmost province of Europe - the Murmansk county (Russia). Birth registry data can be used for monitoring of health inequalities in Russia.