ASSOCIATIONS BETWEEN MEASURES OF SOCIOECONOMIC-STATUS AND MATERNAL HEALTH BEHAVIOR

Lower socioeconomic status (SES) is consistently associated with adver se pregnancy outcomes. One mechanism that may account for this associa tion is that maternal health behaviors vary with SES. To examine this possibility, we addressed how women may be differently categorized by diverse measures of SES and the effect that choice of measure has on t he relationship between SES and maternal health behaviors. We used pop ulation-based data for Caucasian women (n = 10,055) from Alaska, Maine , Oklahoma, and West Virginia who delivered a live infant in 1990-1991 and participated in the Pregnancy Risk Assessment Monitoring System. Five SES measures were evaluated: education; poverty status; Medicaid payment for delivery; Women, Infants, and Children (WIG) enrollment du ring pregnancy; and residential crowding. Three maternal health behavi ors (smoking, delayed/no prenatal care, unintended pregnancy) were exa mined to assess the variation among the associations between SES measu res and behaviors. Item response rates were high for all SES measures (range: 88.9%-100.0%), and there was low correlation between measures. Most of the SES measures were related to maternal health behaviors. H owever, the strength of association varied between each measure and be havior and was weaker for women who were younger than 20 years old or not married. In view of the multifaceted nature of SES, several measur es may be needed to appropriately assess the relationship between SES and maternal health behaviors.