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Life-course Social Mobility and Reduced Risk of Adverse Birth Outcomes

      Introduction

      Higher adult socioeconomic position (SEP) is associated with better birth outcomes. However, few studies incorporate life-course or intergenerational SEP, which may inform etiology and targeted prevention efforts. This study tested whether life-course social mobility from childhood was associated with lower risk of adverse birth outcomes.

      Methods

      Data were from the Life-course Influences of Fetal Environments (LIFE) retrospective cohort study among black women, 2009–2011, in metropolitan Detroit, MI. This study (analyzed in 2014–2016) examined whether social mobility was associated with two primary birth outcomes: small for gestational age (SGA) and preterm birth (PTB). Childhood and adulthood SEP were measured by survey in adulthood, for two constructs, measured ordinally: educational attainment and perceived financial sufficiency (subjective income/wealth). Social mobility was calculated as the difference of adulthood minus childhood SEP.

      Results

      In covariate-adjusted Poisson regression models, 1-SD improved educational social mobility from childhood to adulthood was protective for SGA (adjusted risk ratio=0.76; 95% CI=0.64, 0.91); this association remained after adjusting for financial mobility. Upward financial social mobility from early childhood was marginally protective for SGA (adjusted risk ratio=0.85; 95% CI=0.72, 1.02), but became nonsignificant after controlling educational mobility. There were no overall associations of social mobility with PTB or low birth weight, although sensitivity analyses identified that improved financial mobility was associated with 16% marginally lower risk of spontaneous PTB and 28% marginally lower risk of low birth weight among upwardly mobile/stable women only.

      Conclusions

      Improved life-course social mobility is associated with reduced risk for SGA and spontaneous PTB among black women.
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      References

        • Barker D.
        • Eriksson J.
        • Forsén T.
        • Osmond C.
        Fetal origins of adult disease: strength of effects and biological basis.
        Int J Epidemiol. 2002; 31: 1235-1239https://doi.org/10.1093/ije/31.6.1235
      1. Behrman RE, Butler AS, eds. Preterm Birth: Causes, Consequences, and Prevention. Washington, DC: National Academies Press, 2007

        • Liu L.
        • Johnson H.L.
        • Cousens S.
        • et al.
        Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000.
        Lancet. 2012; 379: 2151-2161https://doi.org/10.1016/S0140-6736(12)60560-1
        • Blumenshine P.
        • Egerter S.
        • Barclay C.J.
        • Cubbin C.
        • Braveman P.A.
        Socioeconomic disparities in adverse birth outcomes: a systematic review.
        Am J Prev Med. 2010; 39: 263-272https://doi.org/10.1016/j.amepre.2010.05.012
        • Nicolaidis C.
        • Ko C.W.
        • Saha S.
        • Koepsell T.D.
        Racial discrepancies in the association between paternal vs. maternal educational level and risk of low birthweight in Washington State.
        BMC Pregnancy Childbirth. 2004; 4: 10https://doi.org/10.1186/1471-2393-4-10
        • DeNavas-Walt C.
        • Proctor B.D.
        Income and Poverty in the United States: 2013. Report P60-249.
        U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau, Washington, DCSeptember 2014
        • Cellini S.R.
        • McKernan S.-M.
        • Ratcliffe C.
        The dynamics of poverty in the United States: a review of data, methods, and findings.
        J Policy Anal Manage. 2008; 27: 577-605https://doi.org/10.1002/pam.20337
        • Lu M.C.
        • Halfon N.
        Racial and ethnic disparities in birth outcomes: a life-course perspective.
        Matern Child Health J. 2003; 7: 13-30https://doi.org/10.1023/A:1022537516969
        • Misra D.P.
        • Guyer B.
        • Allston A.
        Integrated perinatal health framework: A multiple determinants model with a life span approach.
        Am J Prev Med. 2003; 25: 65-75https://doi.org/10.1016/S0749-3797(03)00090-4
        • Geronimus A.T.
        Black/white differences in the relationship of maternal age to birthweight: a population-based test of the weathering hypothesis.
        Soc Sci Med. 1996; 42: 589-597https://doi.org/10.1016/0277-9536(95)00159-X
      2. U.S. Department of Agriculture. Women, Infants and Children (WIC) Eligibility Requirements. www.fns.usda.gov/wic/wic-eligibility-requirements. Accessed April 21, 2016.

        • Collins Jr, J.W.
        • Rankin K.M.
        • David R.J.
        African American women’s lifetime upward economic mobility and preterm birth: the effect of fetal programming.
        Am J Public Health. 2011; 101: 714-719https://doi.org/10.2105/AJPH.2010.195024
        • Colen C.G.
        • Geronimus A.T.
        • Bound J.
        • James S.A.
        Maternal upward socioeconomic mobility and black-white disparities in infant birthweight.
        Am J Public Health. 2006; 96: 2032-2039https://doi.org/10.2105/AJPH.2005.076547
        • Gisselmann M.D.
        The influence of maternal childhood and adulthood social class on the health of the infant.
        Soc Sci Med. 2006; 63: 1023-1033https://doi.org/10.1016/j.socscimed.2006.03.015
        • Astone N.M.
        • Misra D.
        • Lynch C.
        The effect of maternal socio-economic status throughout the lifespan on infant birthweight.
        Paediatr Perinat Epidemiol. 2007; 21: 310-318https://doi.org/10.1111/j.1365-3016.2007.00821.x
        • Joffe M.
        Social inequalities in low birth weight: timing of effects and selective mobility.
        Soc Sci Med. 1989; 28: 613-619https://doi.org/10.1016/0277-9536(89)90256-6
        • Sletner L.
        • Jenum A.K.
        • Morkrid K.
        • et al.
        Maternal life course socio-economic position and offspring body composition at birth in a multi-ethnic population.
        Paediatr Perinat Epidemiol. 2014; 28: 445-454https://doi.org/10.1111/ppe.12137
        • Spencer N.
        Accounting for the social disparity in birth weight: results from an intergenerational cohort.
        J Epidemiol Community Health. 2004; 58: 418-419https://doi.org/10.1136/jech.2003.012757
        • Collins Jr, J.W.
        • David R.J.
        • Rankin K.M.
        • Desireddi J.R.
        Transgenerational effect of neighborhood poverty on low birth weight among African Americans in Cook County, Illinois.
        Am J Epidemiol. 2009; 169: 712-717https://doi.org/10.1093/aje/kwn402
        • Love C.
        • David R.J.
        • Rankin K.M.
        • Collins J.W.
        Exploring weathering: effects of lifelong economic environment and maternal age on low birth weight, small for gestational age, and preterm birth in African-American and white women.
        Am J Epidemiol. 2010; 172: 127-134https://doi.org/10.1093/aje/kwq109
        • Slaughter-Acey J.C.
        • Holzman C.
        • Calloway D.
        • Tian Y.
        Movin’ on up: socioeconomic mobility and the risk of delivering a small-for-gestational age infant.
        Matern Child Health J. 2016; 20: 613-622https://doi.org/10.1007/s10995-015-1860-5
        • Walton K.A.
        • Murray L.J.
        • Gallagher A.M.
        • Cran G.W.
        • Savage M.J.
        • Boreham C.
        Parental recall of birthweight: a good proxy for recorded birthweight?.
        Eur J Epidemiol. 2000; 16: 793-796https://doi.org/10.1023/A:1007625030509
        • Lang J.
        • Lieberman E.
        • Cohen A.
        A comparison of risk factors for preterm labor and term small-for-gestational-age birth.
        Epidemiology. 1996; 7: 369-376https://doi.org/10.1097/00001648-199607000-00006
        • Paneth N.S.
        The problem of low birth weight.
        Future Child. 1995; 5: 26https://doi.org/10.2307/1602505
        • Talge N.M.
        • Mudd L.M.
        • Sikorskii A.
        • Basso O.
        United States birth weight reference corrected for implausible gestational age estimates.
        Pediatrics. 2014; 133: 844-853https://doi.org/10.1542/peds.2013-3285
        • Straughen J.K.
        • Caldwell C.H.
        • Osypuk T.L.
        • Helmkamp L.
        • Misra D.P.
        Direct and proxy recall of childhood socio-economic position and health.
        Paediatr Perinat Epidemiol. 2013; 27: 294-302https://doi.org/10.1111/ppe.12045
        • Hallqvist J.
        • Lynch J.
        • Bartley M.
        • Lang T.
        • Blane D.
        Can we disentangle life course processes of accumulation, critical period and social mobility? An analysis of disadvantaged socio-economic positions and myocardial infarction in the Stockholm Heart Epidemiology Program.
        Soc Sci Med. 2004; 58: 1555-1562https://doi.org/10.1016/S0277-9536(03)00344-7
        • Blau P.M.
        • Duncan O.D.
        The American Occupational Structure.
        Wiley, New York1967
        • Zou G.
        A modified Poisson regression approach to prospective studies with binary data.
        Am J Epidemiol. 2004; 159: 702-706https://doi.org/10.1093/aje/kwh090
        • Rodrigues T.
        • Barros H.
        Comparison of risk factors for small-for-gestational-age and preterm in a portuguese cohort of newborns.
        Matern Child Health J. 2007; 11: 417-424https://doi.org/10.1007/s10995-007-0195-2
        • Heaman M.
        • Kingston D.
        • Chalmers B.
        • Sauve R.
        • Lee L.
        • Young D.
        Risk factors for preterm birth and small-for-gestational-age births among Canadian women.
        Paediatr Perinat Epidemiol. 2013; 27: 54-61https://doi.org/10.1111/ppe.12016
        • Zeitlin J.A.
        • Ancel P.-Y.
        • Saurel-Cubizolles M.-J.
        • Papiernik E.
        Are risk factors the same for small for gestational age versus other preterm births?.
        Am J Obstet Gynecol. 2001; 185: 208-215https://doi.org/10.1067/mob.2001.114869
        • Adler N.E.
        • Epel E.S.
        • Castellazzo G.
        • Ickovics J.R.
        Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy, White women.
        Health Psychol. 2000; 19: 586https://doi.org/10.1037/0278-6133.19.6.586
        • Stringhini S.
        Association of socioeconomic position with health behaviors and mortality.
        JAMA. 2010; 303: 1159-1166https://doi.org/10.1001/jama.2010.297
        • Reardon S.F.
        • Grewal E.T.
        • Kalogrides D.
        • Greenberg E.
        Brown fades: the end of court-ordered school desegregation and the resegregation of American public schools.
        J Policy Anal Manage. 2012; 31: 876-904https://doi.org/10.1002/pam.21649
        • Galobardes B.
        • Lynch J.W.
        • Davey Smith G.
        Childhood socioeconomic circumstances and cause-specific mortality in adulthood: systematic review and interpretation.
        Epidemiol Rev. 2004; 26: 7-21https://doi.org/10.1093/epirev/mxh008
        • Basso O.
        • Olsen J.
        • Johansen A.M.T.
        • Christensen K.
        Change in social status and risk of low birth weight in Denmark: population based cohort study.
        BMJ. 1997; 315: 1498-1502https://doi.org/10.1136/bmj.315.7121.1498
        • Basso O.
        • Olsen J.
        • Christensen K.
        Study of environmental, social, and paternal factors in preterm delivery using sibs and half sibs. A population-based study in Denmark.
        J Epidemiol Community Health. 1999; 53: 20-23https://doi.org/10.1136/jech.53.1.20
        • Mortensen L.H.
        Socioeconomic inequality in birth weight and gestational age in Denmark 1996–2007: using a family-based approach to explore alternative explanations.
        Soc Sci Med. 2013; 76: 1-7https://doi.org/10.1016/j.socscimed.2012.08.021
        • Berney L.R.
        • Blane D.B.
        Collecting retrospective data: accuracy of recall after 50 years judged against historical records.
        Soc Sci Med. 1997; 45: 1519-1525https://doi.org/10.1016/S0277-9536(97)00088-9
        • Batty G.D.
        • Lawlor D.A.
        • Macintyre S.
        • Clark H.
        • Leon D.A.
        Accuracy of adults’ recall of childhood social class: findings from the Aberdeen children of the 1950s study.
        J Epidemiol Community Health. 2005; 59: 898-903https://doi.org/10.1136/jech.2004.030932
        • Liberatos P.
        • Link B.
        • Kelsey J.
        The measurement of social class in epidemiology.
        Epidemiol Rev. 1988; 10: 87-121
        • Osypuk T.L.
        • Joshi P.
        • Geronimo K.
        • Acevedo-Garcia D.
        Do social and economic policies influence health? A review.
        Curr Epidemiol Rep. 2014; 1: 149-164https://doi.org/10.1007/s40471-014-0013-5