The impact of maternal education on intrauterine growth: a comparison of former West and East Germany

Background Objective of this re-analysis of datasets from former East and West Germany was to examine the influence of maternal education on intrauterine growth in two different political and social systems. Methods Information on socio-demographic or lifestyle factors and pregnancy outcome was available for 3374 Liveborn singletons from West Germany (1987/88) and 3070 from East Germany (1990/91). Multiple logistic regression was used to estimate the association between maternal education and the risk of delivering a small-for-gestational-age (SGA) newborn below the 10th percentile of birthweight. Results Women with the lowest education had a significantly elevated risk of SGA newborns compared to women with the highest education in West (odds ratio [OR] = 2.58, 95% CI: 1.17-5.67) and East Germany (OR = 2.77, 95% CI: 1.54-5.00). The distribution of factors known to influence intrauterine growth varied with education in both states. After adjusting for these factors, women with the lowest educational level still had a higher risk of SGA birth: OR (West) = 2.02, 95% CI : 0.87-4.72; OR (East)= 1.95, 95% CI: 1.02-3.74. Conclusions Our findings support the assumption that in former socialist countries health inequalities as a result of social inequalities existed.