A comparative study of educational inequality in the risk of stillbirth in Denmark, Finland, Norway and Sweden 1981-2000

Abstract

Background: The stillbirth rates in Denmark, Finland, Norway and Sweden are among the lowest in the world, but socioeconomic disparities in stillbirth still exist. This study examined the educational patterns in the risk of stillbirth in Denmark, Finland, Norway and Sweden from 1981 to 2000.

Methods: From the national birth registries, all singleton live births and stillbirths with a gestational age of at least 28 weeks were selected in Denmark (n=1 182 888), Finland (n=419 729), Norway (n=1 006 767) and Sweden (n=1 974 101). The births were linked with individual data on parental socioeconomic factors from various national registers. Linear and logistic regression were used to calculate RR and risk differences for stillbirth according to maternal educational attainment.

Results: The risk of stillbirth was lowest in Finland and highest in Denmark. The risk decreased over time in Denmark, Norway and Finland, but remained stable in Sweden. Educational gradients were found in all countries in all time periods under study. In Denmark, the gradient remained stable over time. In Norway the gradient decreased slightly during the 1990s, whereas the gradient increased in Sweden. The gradient in Finland was relatively stable.

Conclusions: There were persisting educational inequalities in stillbirth in Denmark, Finland, Norway and Sweden in the 1980s and 1990s. Inequalities were stable or decreasing except in Sweden, where an increase in inequality was observed. This increase was not solely attributable to a decreasing absolute risk of stillbirth as both the relative and absolute measures of inequality increased.