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Socioeconomic Status Accounts for Rapidly Increasing Geographic Variation in the Incidence of Poor Fetal Growth
Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, P.O. Box 855, West Perth WA 6872, Australia
* Author to whom correspondence should be addressed.
Received: 21 March 2013; in revised form: 3 June 2013 / Accepted: 12 June 2013 / Published: 25 June 2013
Abstract: Fetal growth is an important risk factor for infant morbidity and mortality. In turn, socioeconomic status is a key predictor of fetal growth; however, other sociodemographic factors and environmental effects may also be important. This study modelled geographic variation in poor fetal growth after accounting for socioeconomic status, with a fixed effect for socioeconomic status and a combination of spatially-correlated and spatially-uncorrelated random effects. The dataset comprised 88,246 liveborn singletons, aggregated within suburbs in Perth, Western Australia. Low socioeconomic status was strongly associated with an increased risk of poor fetal growth. An increase in geographic variation of poor fetal growth from 1999–2001 (interquartile odds ratio among suburbs = 1.20) to 2004–2006 (interquartile odds ratio = 1.40) indicated a widening risk disparity by socioeconomic status. Low levels of residual spatial patterns strengthen the case for targeting policies and practices in areas of low socioeconomic status for improved outcomes. This study indicates an alarming increase in geographic inequalities in poor fetal growth in Perth which warrants further research into the specific aspects of socioeconomic status that act as risk factors.
Keywords: poor fetal growth; socioeconomic status; conditional autoregression; spatial variation
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Ball, S.J.; Jacoby, P.; Zubrick, S.R. Socioeconomic Status Accounts for Rapidly Increasing Geographic Variation in the Incidence of Poor Fetal Growth. Int. J. Environ. Res. Public Health 2013, 10, 2606-2620.
Ball SJ, Jacoby P, Zubrick SR. Socioeconomic Status Accounts for Rapidly Increasing Geographic Variation in the Incidence of Poor Fetal Growth. International Journal of Environmental Research and Public Health. 2013; 10(7):2606-2620.
Ball, Stephen J.; Jacoby, Peter; Zubrick, Stephen R. 2013. "Socioeconomic Status Accounts for Rapidly Increasing Geographic Variation in the Incidence of Poor Fetal Growth." Int. J. Environ. Res. Public Health 10, no. 7: 2606-2620.