Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1999 Oct;53(10):624–629. doi: 10.1136/jech.53.10.624

Socioeconomic and work related determinants of pregnancy outcome in southern Thailand

P Tuntiseranee, J Olsen, V Chongsuvivatwong, S Limbutara
PMCID: PMC1756780  PMID: 10616674

Abstract

STUDY OBJECTIVE: To examine the effect of socioeconomic status on pregnancy outcome in an urbanised area in a rapidly developing country. METHODS: A cohort of 1797 pregnant women who attended antenatal care clinics at the two 700 bed hospitals in Hatyai city was recruited from September 1994 to November 1995. The pregnant women were followed up from the 17th week of gestation until delivery. The socioeconomic indicators selected were family socioeconomic status, maternal education, maternal occupation, family income and work exposure characteristics based upon Karasek's job content questionnaires. Pregnancy outcomes were birth weight, low birth weight, small for gestational age and preterm delivery. MAIN RESULTS: Mean birth weight correlated with socioeconomic status and income but after adjustment for parity, maternal age and height, weight at delivery day, baby sex, obstetrical complications and antenatal care utilisation, only family income remained correlated with birth weight. No association with any socioeconomic status indicators was found when using dichotomous outcome (low birth weight, small for gestational age or preterm delivery). Only high psychological job demand was associated with small for gestational age. Confounder adjustment indicated that the observed social status differences in pregnancy outcomes were mainly attributable to mother's characteristics and antenatal service use. CONCLUSIONS: Socioeconomic indicators alone were not associated with reduced fetal growth or preterm delivery in this study, which recruited mainly lower or middle class women. Karasek's psychological job demand was only weakly correlated with small for gestational age infant.

 

Full Text

The Full Text of this article is available as a PDF (88.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abramson J. H., Gofin R., Habib J., Pridan H., Gofin J. Indicators of social class. A comparative appraisal of measures for use in epidemiological studies. Soc Sci Med. 1982;16(20):1739–1746. doi: 10.1016/0277-9536(82)90267-2. [DOI] [PubMed] [Google Scholar]
  2. Antonovsky A., Bernstein J. Social class and infant mortality. Soc Sci Med. 1977 May;11(8-9):453–470. doi: 10.1016/0037-7856(77)90022-1. [DOI] [PubMed] [Google Scholar]
  3. Baird D. Social influences on reproductive performance. J Reprod Fertil Suppl. 1973 Dec;19:585–590. [PubMed] [Google Scholar]
  4. Bell R., Lumley J. Low birthweight and socioeconomic status, Victoria 1982 to 1986. Aust J Public Health. 1992 Mar;16(1):15–19. doi: 10.1111/j.1753-6405.1992.tb00018.x. [DOI] [PubMed] [Google Scholar]
  5. Brandt L. P., Nielsen C. V. Job stress and adverse outcome of pregnancy: a causal link or recall bias? Am J Epidemiol. 1992 Feb 1;135(3):302–311. doi: 10.1093/oxfordjournals.aje.a116284. [DOI] [PubMed] [Google Scholar]
  6. Brooke O. G., Anderson H. R., Bland J. M., Peacock J. L., Stewart C. M. Effects on birth weight of smoking, alcohol, caffeine, socioeconomic factors, and psychosocial stress. BMJ. 1989 Mar 25;298(6676):795–801. doi: 10.1136/bmj.298.6676.795. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Cerón-Mireles P., Harlow S. D., Sánchez-Carrillo C. I. The risk of prematurity and small-for-gestational-age birth in Mexico City: the effects of working conditions and antenatal leave. Am J Public Health. 1996 Jun;86(6):825–831. doi: 10.2105/ajph.86.6.825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Chase H. C. Infant mortality and weight at birth: 1960 United States birth cohort. Am J Public Health Nations Health. 1969 Sep;59(9):1618–1628. doi: 10.2105/ajph.59.9.1618. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Chumnijarakij T., Nuchprayoon T., Chitinand S., Onthuam Y., Quamkul N., Dusitsin N., Viputsiri O. A., Chotiwan P., Limpongsanurak S., Sukomol P. Maternal risk factors for low birth weight newborn in Thailand. J Med Assoc Thai. 1992 Aug;75(8):445–452. [PubMed] [Google Scholar]
  10. Cramer J. C. Racial and ethnic differences in birthweight: the role of income and financial assistance. Demography. 1995 May;32(2):231–247. [PubMed] [Google Scholar]
  11. DaVanzo J., Habicht J. P., Butz W. P. Assessing socioeconomic correlates of birthweight in peninsular Malaysia: ethnic differences and changes over time. Soc Sci Med. 1984;18(5):387–404. doi: 10.1016/0277-9536(84)90056-x. [DOI] [PubMed] [Google Scholar]
  12. Dunn H. G. Social aspects of low birth weight. Can Med Assoc J. 1984 May 1;130(9):1131–1140. [PMC free article] [PubMed] [Google Scholar]
  13. Hemminki E., Malin M., Rahkonen O. Mother's social class and perinatal problems in a low-problem area. Int J Epidemiol. 1990 Dec;19(4):983–990. doi: 10.1093/ije/19.4.983. [DOI] [PubMed] [Google Scholar]
  14. Henriksen T. B., Hedegaard M., Secher N. J. The relation between psychosocial job strain, and preterm delivery and low birthweight for gestational age. Int J Epidemiol. 1994 Aug;23(4):764–774. doi: 10.1093/ije/23.4.764. [DOI] [PubMed] [Google Scholar]
  15. Homer C. J., James S. A., Siegel E. Work-related psychosocial stress and risk of preterm, low birthweight delivery. Am J Public Health. 1990 Feb;80(2):173–177. doi: 10.2105/ajph.80.2.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Joffe M. Social inequalities in low birth weight: timing of effects and selective mobility. Soc Sci Med. 1989;28(6):613–619. doi: 10.1016/0277-9536(89)90256-6. [DOI] [PubMed] [Google Scholar]
  17. Kramer M. S. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65(5):663–737. [PMC free article] [PubMed] [Google Scholar]
  18. Lardelli P., Blanco J. I., Delgado-Rodríguez M., Bueno A., de Dios Luna J., Gálvez R. Influence of socioeconomic and health care development on infant and perinatal mortality in Spain 1975-86. J Epidemiol Community Health. 1993 Aug;47(4):260–264. doi: 10.1136/jech.47.4.260. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Liberatos P., Link B. G., Kelsey J. L. The measurement of social class in epidemiology. Epidemiol Rev. 1988;10:87–121. doi: 10.1093/oxfordjournals.epirev.a036030. [DOI] [PubMed] [Google Scholar]
  20. Lumley J., Correy J. F., Newman N. M., Curran J. T. Cigarette smoking, alcohol consumption and fetal outcome in Tasmania 1981-82. Aust N Z J Obstet Gynaecol. 1985 Feb;25(1):33–40. doi: 10.1111/j.1479-828x.1985.tb00599.x. [DOI] [PubMed] [Google Scholar]
  21. Mackenbach J. P. Socio-economic health differences in The Netherlands: a review of recent empirical findings. Soc Sci Med. 1992 Feb;34(3):213–226. doi: 10.1016/0277-9536(92)90264-q. [DOI] [PubMed] [Google Scholar]
  22. Mavalankar D. V., Gray R. H., Trivedi C. R. Risk factors for preterm and term low birthweight in Ahmedabad, India. Int J Epidemiol. 1992 Apr;21(2):263–272. doi: 10.1093/ije/21.2.263. [DOI] [PubMed] [Google Scholar]
  23. McCormick M. C. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med. 1985 Jan 10;312(2):82–90. doi: 10.1056/NEJM198501103120204. [DOI] [PubMed] [Google Scholar]
  24. Morrison J., Najman J. M., Williams G. M., Keeping J. D., Andersen M. J. Socio-economic status and pregnancy outcome. An Australian study. Br J Obstet Gynaecol. 1989 Mar;96(3):298–307. doi: 10.1111/j.1471-0528.1989.tb02389.x. [DOI] [PubMed] [Google Scholar]
  25. Nordström M. L., Cnattingius S. Effects on birthweights of maternal education, socio-economic status, and work-related characteristics. Scand J Soc Med. 1996 Mar;24(1):55–61. doi: 10.1177/140349489602400109. [DOI] [PubMed] [Google Scholar]
  26. Olsen J., Frische G. Social differences in reproductive health. A study on birth weight, stillbirths and congenital malformations in Denmark. Scand J Soc Med. 1993 Jun;21(2):90–97. doi: 10.1177/140349489302100206. [DOI] [PubMed] [Google Scholar]
  27. Paneth N., Susser M. Early origin of coronary heart disease (the "Barker hypothesis") BMJ. 1995 Feb 18;310(6977):411–412. doi: 10.1136/bmj.310.6977.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Parker J. D., Schoendorf K. C., Kiely J. L. Associations between measures of socioeconomic status and low birth weight, small for gestational age, and premature delivery in the United States. Ann Epidemiol. 1994 Jul;4(4):271–278. doi: 10.1016/1047-2797(94)90082-5. [DOI] [PubMed] [Google Scholar]
  29. Peacock J. L., Bland J. M., Anderson H. R. Preterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine. BMJ. 1995 Aug 26;311(7004):531–535. doi: 10.1136/bmj.311.7004.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Peters T. J., Golding J., Butler N. R., Fryer J. G., Lawrence C. J., Chamberlain G. V. Plus ça change: predictors of birthweight in two national studies. Br J Obstet Gynaecol. 1983 Nov;90(11):1040–1045. doi: 10.1111/j.1471-0528.1983.tb06442.x. [DOI] [PubMed] [Google Scholar]
  31. Rodríguez C., Regidor E., Gutiérrez-Fisac J. L. Low birth weight in Spain associated with sociodemographic factors. J Epidemiol Community Health. 1995 Feb;49(1):38–42. doi: 10.1136/jech.49.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Rutter D. R., Quine L. Inequalities in pregnancy outcome: a review of psychosocial and behavioural mediators. Soc Sci Med. 1990;30(5):553–568. doi: 10.1016/0277-9536(90)90154-k. [DOI] [PubMed] [Google Scholar]
  33. Saugstad L. F. Weight of all births and infant mortality. J Epidemiol Community Health. 1981 Sep;35(3):185–191. doi: 10.1136/jech.35.3.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Seidman D. S., Samueloff A., Mor-Yosef S., Schenker J. G. The effect of maternal age and socioeconomical background on neonatal outcome. Int J Gynaecol Obstet. 1990 Sep;33(1):7–12. doi: 10.1016/0020-7292(90)90647-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES