Study: Neighbourhood income, maternal education and birth outcomes in Quebec

1991 to 2000

Women with lower levels of education and those who live in poorer neighbourhoods are more vulnerable to adverse birth outcomes, according to a new study.

The study, which examined all births in Quebec from 1991 through 2000, found that the mother's level of education and the socio-economic status of the neighbourhood in which she lived were associated with higher risks of pre-term birth, small-for-gestational age birth, stillbirth, neonatal death and post-neonatal death.

The impacts of maternal education were stronger than those of neighbourhood income, and were independent of neighbourhood income, according to the study.

In both urban and rural areas, the effects of low maternal education were strongest for small-for-gestational-age births and post-neonatal death.

The large beneficial impact of higher maternal education on post-neonatal mortality may operate through better knowledge of infant care, especially sleep position, as evidenced by important differences in the risks of sudden infant death syndrome.

Mothers with low education in rural areas seemed more vulnerable to neonatal death, particularly for death due to immaturity-related conditions. The authors speculate that access to high-quality neonatal intensive care may be more limited for mothers with low education in rural settings.

The findings suggest that in both urban and rural areas, lesser-educated women and those from poorer neighbourhoods may benefit from heightened vigilance and counselling from perinatal care providers, the study said.

Definitions, data sources and methods: survey numbers, including related surveys, 3231, 3233 and 3234.

The study "Effect of neighbourhood income and maternal education on birth outcomes: A Population-based study" published in the Canadian Medical Association Journal, is a collaboration of Statistics Canada, the University of Montréal, and McGill University. The full text of the article is available free, in English only, at (http://www.cmaj.ca).

For more information, or to enquire about the concepts, methods or data quality of the study, or to obtain a copy, contact Russell Wilkins (1-613-951-5305; russell.wilkins@statcan.gc.ca), Health Analysis and Measurement Group.