Beyond biology: the social context of prenatal behaviour and birth outcomes

Objectives: In this study we examine the factors that are associated with a dverse birth outcomes using a representative national sample. In our analys is we take into account factors which are related to the mother's behaviour during pregnancy and also consider the socio-economic circumstances of the family. Methods: A series of logistic regression models are used to determine the i ncreased risks of low birth weight, preterm, and small for gestational age births associated with maternal smoking, alcohol consumption and high blood pressure in relation to socio-economic factors, such as family dysfunction , social support, income adequacy, age, and education. Results: All socio-e conomic factors showed gradients of maternal smoking during pregnancy while only mother's education and socio-economic status demonstrated gradients o f alcohol use and high blood pressure. Maternal smoking, high blood pressur e, higher levels of family dysfunction, and lower levels of mother's educat ion were found to significantly increase the risk of an adverse birth outco me. Conclusions: Interventions designed to mitigate the hazards of adverse birt h outcomes should be designed to reflect the gradients of risky prenatal ma ternal behaviours associated with age, education, income, and family dysfun ction.