Explaining the Social Gradient in Smoking in Pregnancy : Early Life Course Accumulation and Cross Sectional Clustering of Social Risk Exposures in th 1958 British National Cohort  

Oleh:

Spencer, Nick

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Social Science & Medicine (www.elsevier.com/locate/sosscimed) vol. 62 no. 5 (Mar. 2006), page 1250-1259.
Topik: smoking; pregnancy smoking; social gradient; cumulative social risk; cross sectional clustering of social risk; UK

Ketersediaan

Perpustakaan Pusat (Semanggi) Nomor Panggil: SS53.2 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Smoking in pregnancy is a major determinant of low birthwright and a range of adverse infant health outcomes. There is a well established social gradient in smoking in pregnancy in the US and northern europe. Social gradients in health related behaviours may result from longitudinal accumulation and cross sectional clustering of social risk exposures. There is however no published confirmation of this explanation in empirical data with smoking in pregnancy as the outcome. This study aimed to test the effects of longitudinal accumulation and cross sectional clustering of social risk exposures on smoking in pregnancy using data on the first pregnancies of 3163 female members of the 1958 british national cohort. Social class at birth and aged 11 years was under to create three dichotomous variables representing cumulative social class (both manual, one manual and one non manual, both non manual) early on the lifecourse. Cross sectional clustering of social risk was represented by four dichotomous variables created from combination of maternal age (< 20 vs 20 +) own social class (manual vs non manual and educational attainment (low vs other). Cumulative social class in early childhood was associated with smoking in pregnancy in bivariate analysis but not after adjustment for cross sectional clustering of social risk exposures. However, women who had been in the manual social groups at birth and 11 years were at increased risk of cross sectional clustering of social risk exposures around pregnancy suggesting a pathway from early childhood was associated with smoking in pregnancy in bivariate analysis but not after adjustment for cross sectional clustering of social risk exposures. However women who had been in the manual social groups at birth and 11 years were at increased risk of cross sectional clustering of social risk exposures around pregnancy suggesting a pathway from early lifecourse risk exposure to social risk factors associated with a high risk of smoking in pregnancy. These findings suggest that the social gradient in smoking in pregnancy results from longitudinal accumulation and cross sectional clustering of social risk exposures. Interventions aimed at reducing social inequalities in smoking in pregnancy need to account for cumulative and cross sectionally clustered effects of social risk exposures.

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