Is individual social deprivation associated with adverse perinatal outcomes? Results of a French multicentre cross-sectional survey

Abstract

Introduction: French national health programmes take into account social deprivation in their implementation, those targeting perinatal outcomes, especially. The main aim of the present work was to assess the association between individual social deprivation and adverse perinatal outcomes.

Methods: A multicentre cross-sectional population-based survey was performed between October and December 2007. Eligible women delivered a baby in one of the three maternity hospitals of Clermont-Ferrand area, and read and spoke French fluently. Women who had undergone voluntary termination of pregnancy were excluded. Individual social deprivation was measured by the EPICES score. Standard prenatal follow-up defined by having less than 7 consultations and quality of prenatal care defined by having at least four consultations were measured. Adverse perinatal outcomes were measured by a composite criterion defined by women who had the occurrence of the three main causes of pregnancy-related disorders: preterm delivery, and/or diabetes, and/or obstetrical hypertension.

Results: Of the 471 eligible women, 464 were finally included. One hundred and fifteen (24.78%) women were socially deprived. The most deprived women had poor standard prenatal follow-up (p = 0.003) and poor quality of prenatal care (0.03). Nationality was the sole confounding factor identified. Deprived women had a two-fold greater risk of adverse perinatal outcomes, adjusted odds ratio 1.95 [1.15; 3.29].

Discussion: Social deprivation was associated with adverse perinatal outcomes. Social deprivation should be systematically screened in pregnant women standard follow-up, among migrant women, especially.

Keywords: Adverse perinatal outcomes; EPICES score; Individual Social deprivation; Preterm birth.