Influence of Socio-Economic Factors and Region of Birth on the Risk of Preeclampsia in Sweden
Mattsson, Kristina LU ; Juárez, Sol LU and Malmqvist, Ebba LU
(2022)
In International Journal of Environmental Research and Public Health
19(7).
- Abstract
Objectives: To investigate the association between socio-economic factors and the risk of preeclampsia in Sweden, specifically investigating if this relationship is confounded by maternal region of birth. Study design: All singleton births between 1999 and 2009 in an ethnically diverse area in southern Sweden, totaling 46,618 pregnancies, were included in this study. The data on maternal pregnancy outcomes were retrieved from a regional birth register and socio-economic variables from Statistics Sweden. The risk ratios for preeclampsia were calculated for educational level and household disposable income, adjusting for maternal region of birth, maternal age, body mass index, parity, and smoking. Results: Low income levels were... (More)
Objectives: To investigate the association between socio-economic factors and the risk of preeclampsia in Sweden, specifically investigating if this relationship is confounded by maternal region of birth. Study design: All singleton births between 1999 and 2009 in an ethnically diverse area in southern Sweden, totaling 46,618 pregnancies, were included in this study. The data on maternal pregnancy outcomes were retrieved from a regional birth register and socio-economic variables from Statistics Sweden. The risk ratios for preeclampsia were calculated for educational level and household disposable income, adjusting for maternal region of birth, maternal age, body mass index, parity, and smoking. Results: Low income levels were associated with a higher risk for preeclampsia, adjusted risk ratio (aRR) = 1.25 (95% confidence interval [CI]: 0.99, 1.59) and aRR = 1.36 (95% CI: 1.10, 1.68) for the two lowest quintiles, respectively, compared to the highest. There was an educational gradient in preeclampsia risk, although not all categories reached statistical significance: aRR = 1.16, (95% CI: 0.89–1.50) for low educational attainment and aRR = 1.23 (95% CI: 1.08, 1.41) for intermediate educational attainment compared to women with highest education. The socio-economic gradient remained after adjusting for region of birth. There was a lower risk for preeclampsia for women born in Asia, aRR = 0.60 (95% CI: 0.47, 0.75), regardless of socio-economic position. Conclusion: An increased risk for preeclampsia was seen for women with measures of lower socio-economic position, even in a universal, government-funded healthcare setting. The relationship was not explained by region of birth, indicating that the excess risk is not due to ethnically differential genetic pre-disposition but rather due to modifiable factors.
(Less)
- author
- Mattsson, Kristina
LU
; Juárez, Sol
LU
and Malmqvist, Ebba
LU
- organization
- publishing date
- 2022-04
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- immigrant health, preeclampsia, pregnancy health, region of birth, socio-economic factors
- in
- International Journal of Environmental Research and Public Health
- volume
- 19
- issue
- 7
- article number
- 4080
- publisher
- MDPI AG
- external identifiers
-
- scopus:85127071061
- pmid:35409763
- ISSN
- 1661-7827
- DOI
- 10.3390/ijerph19074080
- language
- English
- LU publication?
- yes
- id
- 73dd224d-91f1-40ab-9378-7d44af8cc16e
- date added to LUP
- 2022-05-04 14:24:13
- date last changed
- 2024-06-13 12:20:56
@article{73dd224d-91f1-40ab-9378-7d44af8cc16e,
abstract = {{<p>Objectives: To investigate the association between socio-economic factors and the risk of preeclampsia in Sweden, specifically investigating if this relationship is confounded by maternal region of birth. Study design: All singleton births between 1999 and 2009 in an ethnically diverse area in southern Sweden, totaling 46,618 pregnancies, were included in this study. The data on maternal pregnancy outcomes were retrieved from a regional birth register and socio-economic variables from Statistics Sweden. The risk ratios for preeclampsia were calculated for educational level and household disposable income, adjusting for maternal region of birth, maternal age, body mass index, parity, and smoking. Results: Low income levels were associated with a higher risk for preeclampsia, adjusted risk ratio (aRR) = 1.25 (95% confidence interval [CI]: 0.99, 1.59) and aRR = 1.36 (95% CI: 1.10, 1.68) for the two lowest quintiles, respectively, compared to the highest. There was an educational gradient in preeclampsia risk, although not all categories reached statistical significance: aRR = 1.16, (95% CI: 0.89–1.50) for low educational attainment and aRR = 1.23 (95% CI: 1.08, 1.41) for intermediate educational attainment compared to women with highest education. The socio-economic gradient remained after adjusting for region of birth. There was a lower risk for preeclampsia for women born in Asia, aRR = 0.60 (95% CI: 0.47, 0.75), regardless of socio-economic position. Conclusion: An increased risk for preeclampsia was seen for women with measures of lower socio-economic position, even in a universal, government-funded healthcare setting. The relationship was not explained by region of birth, indicating that the excess risk is not due to ethnically differential genetic pre-disposition but rather due to modifiable factors.</p>}},
author = {{Mattsson, Kristina and Juárez, Sol and Malmqvist, Ebba}},
issn = {{1661-7827}},
keywords = {{immigrant health; preeclampsia; pregnancy health; region of birth; socio-economic factors}},
language = {{eng}},
number = {{7}},
publisher = {{MDPI AG}},
series = {{International Journal of Environmental Research and Public Health}},
title = {{Influence of Socio-Economic Factors and Region of Birth on the Risk of Preeclampsia in Sweden}},
url = {{http://dx.doi.org/10.3390/ijerph19074080}},
doi = {{10.3390/ijerph19074080}},
volume = {{19}},
year = {{2022}},
}