LOW-BIRTH-WEIGHT, PRETERM, AND SMALL-FOR-GESTATIONAL-AGE BABIES IN SCOTLAND, 1981-1984

Study objective-The aim was to examine the effect of maternal age, gravidity, marital status, previous perinatal deaths, and parental social class on babies born low birthweight, preterm, and small for gestational age. Design-The study used data on discharge summaries from all maternity hospitals in Scotland. Setting-The study was based on all singleton deliveries in Scotland. Participants-The analysis involved information on 259 462 singleton babies born during the four years 1981-84 in Scotland. Measurements and main results-Previous perinatal death was found to be the strongest predictor for both preterm and low birthweight. Single mothers were at particularly high risk of having a small for gestational age baby and those who were previously married of having a preterm baby. Women aged less than 20 years old, those over 34 years old, nulligravidae, and those of parity 3 or more were also at increased risk of adverse pregnancy outcome. Mothers and fathers in manual social classes and those who could not be assigned a social class on the basis of their occupation were at increased risk for all three adverse outcomes studied. The babies of parents who were in manual occupations were twice as likely as those of parents in non-manual occupations to be small for gestational age and almost twice as likely to be low birthweight. Conclusions-Mother's social class is a risk factor for adverse pregnancy outcome independent of maternal age, parity, and adverse reproductive history, and also independent of father's social class. Information on both parents' occupations should be collected in maternity discharge systems.