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Socioeconomic Disparities in Adverse Birth Outcomes in Urban and Rural Contexts: a French Mother-Child Cohort

Abstract : BACKGROUND: Although adverse birth outcomes have been associated with neighbourhood deprivation in urban areas, few studies have addressed this issue in rural zones. This study examines whether associations between neighbourhood deprivation and adverse birth outcomes differ in urban and rural contexts, while taking individual characteristics and spatial accessibility of prenatal care (SAPC) into account. METHODS: Pregnant women from a French mother-child cohort were recruited from 2002 to 2006 in Brittany. Their residential addresses were geocoded into their census blocks (the finest geographical resolution available). Deprivation was assessed at the same neighbourhood level. Models to assess the associations of deprivation, stratified by urban/rural status, with preterm delivery (PTD), with small for gestational age birth weight (SGA) and with small for gestational age head circumference at birth (SHC), estimated odds ratios (ORs), adjusted for maternal socioeconomic characteristics and SAPC. RESULTS: This study considered 2929 liveborn singleton pregnancies from 780 census blocks. Neighbourhood deprivation was associated with increased risks of SGA and SHC (P trend \textless 0.01 and 0.03 respectively), only among mothers residing in rural areas. Neighbourhood deprivation had statistically significantly heterogeneous effects on SGA and SHC according to the urban/rural status of maternal residence. CONCLUSION: These findings suggest that neighbourhood deprivation affects fetal growth differentially in urban and rural areas and that SAPC does not seem to be responsible for this difference. Comparison of these findings with the literature requires caution in the conceptualisation of urban and rural settings
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187424
Contributor : Laurent Jonchère <>
Submitted on : Wednesday, August 26, 2015 - 4:50:54 PM
Last modification on : Wednesday, March 4, 2020 - 9:43:46 AM

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Mélanie Bertin, Jean-François Viel, Christine Monfort, Sylvaine Cordier, Cécile Chevrier. Socioeconomic Disparities in Adverse Birth Outcomes in Urban and Rural Contexts: a French Mother-Child Cohort. Paediatric and Perinatal Epidemiology, Wiley, 2015, 29 (5), pp.426--435. ⟨10.1111/ppe.12208⟩. ⟨hal-01187424⟩

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