The first years of life are crucial in building the foundation for health and well-being throughout childhood and in later life. The DRIVERS project has focused on early childhood as one of three key policy areas for improving health equity in Europe. Although a healthy start to life is a major priority across European countries, the regional-level evidence of inequalities in health among newborns is limited.
A large-scale study, led by Milagros Ruiz from University College London as a part of DRIVERS, sought to advance the state-of-the-art knowledge in this area. The study examined the health of over 75,000 babies from 12 countries (Czech Republic, Finland, France, Greece, Italy, the Netherlands, Norway, Portugal, Spain, Sweden, the United Kingdom and Ukraine) representative of the cultural, geographical and historical diversity across Europe. The study looked at the effect of low maternal education upon babies’ risk of being born either too soon, or too small for their gestational age.
The study found that low maternal education was linked with a discernible risk of pre-term and small for gestational age births in Europe. There is substantial evidence that both preterm (and small for gestational age) births are critical aspects of foetal nutrition and health among newborns. In fact, these aspects have been attributed to impaired child development and an increased risk of chronic diseases in adult life. On average, the increased risk of poor health at birth associated with low maternal education was 48% greater for preterm births and 55% greater for small for gestational age births across 12 countries.
However, the associations between low maternal education and poor health at birth within each country were most robust in the Netherlands, Spain, Sweden and the UK, for both health outcomes. These associations were weaker in the other countries studied. The study authors are continuing their work for DRIVERS, and are further assessing the differential effect of mother’s education as a social determinant of newborn health in participating countries.
These findings provide a clearer picture of inequalities in newborn health associating with low maternal education in distinct European settings. Such inequalities may be alleviated by universal and high-quality care and education for babies and their families, which would contribute to creating more supportive environments for disadvantaged communities.
The study published in the Journal of Epidemiology and Community Health, ‘Mother's education and the risk of preterm and small for gestational age birth: a DRIVERS meta-analysis of 12 European cohorts’, can be accessed here: http://jech.bmj.com/content/early/2015/04/23/jech-2014-205387.long.