Abstract
BackgroundSuboptimal maternal health conditions (such as obesity, underweight, depression and stress) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition) during pregnancy have been associated with negative pregnancy outcomes. Our first aim was to give an overview of the self-reported health status and health behaviours of pregnant women under midwife-led primary care in the Netherlands. Our second aim was to identify potential differences in these health status indicators and behaviours according to educational level (as a proxy for socio-economic status) and ethnicity (as a proxy for immigration status).MethodsOur cross-sectional study (data obtained from the DELIVER multicentre prospective cohort study conducted from September 2009 to March 2011) was based on questionnaires about maternal health and prenatal care, which were completed by 6711 pregnant women. The relationships of education and ethnicity with 13 health status indicators and 10 health behaviours during pregnancy were examined using multilevel multiple logistic regression analyses, adjusted for age, parity, number of weeks pregnant and either education or ethnicity.ResultsLower educated women were especially more likely to smoke (Odds Ratio (OR) 11.3; 95 % confidence interval (CI) 7.6– 16.8); have passive smoking exposure (OR 6.9; 95 % CI 4.4–11.0); have low health control beliefs (OR 10.4; 95 % CI 8.5–12.8); not attend antenatal classes (OR 4.5; 95 % CI 3.5–5.8) and not take folic acid supplementation (OR 3.4; 95 % CI 2.7–4.4). They were also somewhat more likely to skip breakfast daily, be obese, underweight and depressed or anxious. Non-western women were especially more likely not to take folic acid supplementation (OR 4.5; 95 % CI 3.5–5.7); have low health control beliefs (OR 4.1; 95 % CI 3.1–5.2) and not to attend antenatal classes (OR 3.3; 95 % CI 2.0–5.4). They were also somewhat more likely to have nausea, back pains and passive smoking exposure.ConclusionsSubstantial socio-demographic inequalities persist with respect to many health-related issues in medically low risk pregnancies in the Netherlands. Improved strategies are needed to address the specific needs of socio-demographic groups at higher risk and the structures underlying social inequalities in pregnant women.
Highlights
IntroductionSuboptimal maternal health conditions (such as obesity, underweight, depression and stress) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition) during pregnancy have been associated with negative pregnancy outcomes
Suboptimal maternal health conditions and health behaviours during pregnancy have been associated with negative pregnancy outcomes
In order to inform and to better tailor and target interventions to promote positive maternal health and pregnancy outcomes, it is important to gain a better insight into the differences in prevalence of suboptimal maternal health indicators and behaviours across social groups
Summary
Suboptimal maternal health conditions (such as obesity, underweight, depression and stress) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition) during pregnancy have been associated with negative pregnancy outcomes. Suboptimal maternal health conditions (such as obesity, underweight, stress and depression [3,4,5,6,7,8]) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition [9,10,11,12]) have been associated with adverse pregnancy outcomes. Suboptimal health conditions and behaviours are consistently found to be more prevalent among people from lower socio-economic status –for example as indicated by lower levels of educationand immigrant status Such differences are important determinants of health inequalities in general [13, 14] and during pregnancy [15, 16]. In order to inform and to better tailor and target interventions to promote positive maternal health and pregnancy outcomes, it is important to gain a better insight into the differences in prevalence of suboptimal maternal health indicators and behaviours across social groups
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