Department of Preventive Medicine, Korea University, Seoul, Republic of Korea.
Department of Obstetrics & Gynecology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Matern Child Health J. 2023 Jan;27(1):111-116. doi: 10.1007/s10995-022-03542-y. Epub 2022 Nov 9.
To assess the risk gradient of chromosomal abnormalities and fetal or neonatal death across a socioeconomic spectrum of pregnant women.
We used the data from the Korean Prenatal Diagnosis Study (KPDS), which included singleton pregnancies who were candidates for fetal aneuploidy screening enrolled from the Seoul Capital Area from December 2016 to April 2018. We analyzed chromosomal abnormalities which were diagnosed pre- or postnatally, and fetal or neonatal death. The highest level of education among the women and the average monthly household income were used as proxies for socioeconomic status.
Among the 6,715 women, the majority of were 30-39 years old and university graduates, with a reported household income higher than the national median. Chromosomal abnormalities occurred in 45 women (6.7 per 1,000). Fetal or neonatal death occurred in 70 (11.3 per 1,000), excluding pregnancies affected by chromosomal abnormality diagnosis. The adjusted odds ratio for chromosomal abnormalities was higher when household income was < 4,484 USD per month. For fetal or neonatal death, the risk estimates for lower education and lower household income were generally positive but remained imprecise.
We observed some evidence of an inverse association between the risk of fetal chromosomal abnormality and level of household income in a prospective cohort of pregnant women. Interventions to reduce socioeconomic disparities in perinatal health should focus on those with a low household income.
评估孕妇社会经济谱中染色体异常和胎儿或新生儿死亡的风险梯度。
我们使用了韩国产前诊断研究(KPDS)的数据,该研究包括 2016 年 12 月至 2018 年 4 月期间来自首尔首都圈的候选胎儿非整倍体筛查的单胎妊娠。我们分析了产前或产后诊断的染色体异常以及胎儿或新生儿死亡。女性的最高受教育程度和家庭月平均收入被用作社会经济地位的代表。
在 6715 名女性中,大多数年龄在 30-39 岁,为大学毕业生,家庭收入高于全国中位数。45 名女性(每 1000 名中 6.7 名)发生染色体异常。70 名(每 1000 名中 11.3 名)发生胎儿或新生儿死亡,不包括受染色体异常诊断影响的妊娠。当家庭收入<4484 美元/月时,染色体异常的调整比值比更高。对于胎儿或新生儿死亡,受教育程度较低和家庭收入较低的风险估计值通常为正,但仍然不精确。
我们在一组前瞻性孕妇队列中观察到胎儿染色体异常风险与家庭收入水平之间存在负相关的一些证据。减少围产期健康中社会经济差异的干预措施应侧重于收入较低的人群。