Socioeconomic disparities in preterm birth and birth weight in a non-Western developed setting: evidence from Hong Kong's 'Children of 1997' birth cohort.

BACKGROUND

Preterm birth (PTB), low birth weight and small-for-gestational age (SGA) are associated with lower socioeconomic position (SEP) in developed Western settings, but it is unclear if such disparities persist to the same extent elsewhere, and whether associations differ by measure of SEP used. Here, we assessed the association of SEP with PTB, birth weight and SGA in the recently developed non-Western setting of Hong Kong where few women smoke or use alcohol.

METHODS

We used multivariable logistic and linear regression to assess the associations of parental and neighbourhood SEP with PTB, birth weight and SGA among 8173 singleton births from the Hong Kong population-representative 'Children of 1997' birth cohort.

RESULTS

The only measure of SEP associated with PTB was type of housing adjusted for maternal age (p for trend 0.046). Highest paternal education had a small positive association with birth weight adjusted for gestational age (21 g, 95% CI 0.2 to 43 g for ≥grade 12 compared with ≤grade 9), as did residing in private compared with public housing (21 g, 95% CI 3 to 39 g). However, these associations did not persist after adjusting for mother's age. Lower neighbourhood Gini coefficient adjusted for mother's age was associated with a lower risk of SGA (OR 0.78, 95% CI 0.63 to 0.98). None of these associations remained after adjusting for multiple comparisons.

CONCLUSIONS

PTB, birth weight and SGA may be less clearly socially patterned in Hong Kong than other developed settings, highlighting the need for setting-specific interventions to prevent adverse birth outcomes.