National Research and Development Centre for Welfare and Health, Helsinki, Finland.
J Epidemiol Community Health. 2009 Jun;63(6):420-5. doi: 10.1136/jech.2008.079921. Epub 2009 Feb 11.
Socioeconomic differences in perinatal health decreased in Finland in the late 1990s. Whether the decreasing socioeconomic differences in perinatal health observed in Finland in the late 1990s have continued in 2000-6 was studied.
The data were based on 965 443 births and 931 285 singletons recorded between 1991 and 2006 in the Finnish Medical Birth Register. Information on socioeconomic position was based on maternal occupation. Perinatal health was measured with six different indicators.
The proportions of preterm, low birthweight and SGA (small-for-gestational-age) births remained stable during the study period, but decreased for LGA (large-for-gestational-age) births and perinatal death. After adjustment for maternal background variables, the socioeconomic differences in preterm and low-birthweight births decreased in the late 1990s and remained low thereafter. In 2003-6, blue-collar workers had a 14% (95% CI 7% to 22%) higher risk for preterm birth and a 25% (95% CI 16% to 34%) higher risk for low birthweight than upper white-collar workers. For SGA, the socioeconomic differences remained unchanged, and the excess risk for blue-collar workers was 44% (95% CI 31% to 58%) in 2003-6. For LGA, the socioeconomic differences increased, and the highest excess risks were obtained among lower white-collar (23%, 95% CI 15% to 33%) and blue-collar workers (24%, 95% CI 14% to 36%). The differences in perinatal mortality decreased until the late 1990s, but increased thereafter. In 2003-6, lower white-collar and blue-collar workers had the highest excess risks: 46% (95% CI 20% to 77%) and 44% (95% CI 13% to 83%), respectively.
The trends in social inequality in perinatal health outcomes were diverging by indicator. The positive trend on diminishing socioeconomic differences found in the 1990s seems to have come to an end.
20 世纪 90 年代末，芬兰的围产健康的社会经济差异有所缩小。本研究旨在探讨芬兰在 2000-2006 年期间是否延续了 20 世纪 90 年代末观察到的围产健康的社会经济差异缩小趋势。
本研究的数据基于芬兰医学出生登记处 1991 年至 2006 年间记录的 965443 例分娩和 931285 例单胎妊娠。社会经济地位的信息基于母亲的职业。围产健康采用 6 个不同指标进行测量。
研究期间，早产、低出生体重和 SGA（小于胎龄儿）的比例保持稳定，但 LGA（大于胎龄儿）和围产儿死亡的比例有所下降。调整了母亲的背景变量后，20 世纪 90 年代末，早产和低出生体重的社会经济差异缩小，此后一直保持较低水平。2003-2006 年，蓝领工人的早产风险比白领工人高 14%（95%CI 7%-22%），低出生体重风险高 25%（95%CI 16%-34%）。对于 SGA，社会经济差异保持不变，蓝领工人的超额风险为 44%（95%CI 31%-58%）。对于 LGA，社会经济差异增大，风险最高的是低级别白领（23%，95%CI 15%-33%）和蓝领工人（24%，95%CI 14%-36%）。围产儿死亡率的差异在 20 世纪 90 年代末之前缩小，但此后有所增加。2003-2006 年，低级别白领和蓝领工人的超额风险最高，分别为 46%（95%CI 20%-77%）和 44%（95%CI 13%-83%）。
不同指标下，围产健康结局的社会不平等趋势正在分化。20 世纪 90 年代发现的社会经济差异缩小的积极趋势似乎已经结束。
