Adverse Birth Outcomes as Indicators of Poor Fetal Growth Conditions in a French Newborn Population—A Stratified Analysis by Neighborhood Deprivation Level

Wahida Kihal-Talantikite, Pauline Le Nouveau, Pierre Legendre, Denis Zmirou Navier, Arlette Danzon, Marion Carayol and Séverine Deguen
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Wahida Kihal-Talantikite: LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 6700 Strasbourg, France
Pauline Le Nouveau: EHESP School of Public Health, 35043 CEDEX Rennes, France
Pierre Legendre: EHESP School of Public Health, 35043 CEDEX Rennes, France
Denis Zmirou Navier: INSERM U1085 IRSET (Research Institute in Environmental and Occupational Health), 35000 CEDEX Rennes, France
Arlette Danzon: City of Paris Maternal and infant health department (PMI), 75018 Paris, France
Marion Carayol: City of Paris Maternal and infant health department (PMI), 75018 Paris, France
Séverine Deguen: EHESP School of Public Health, 35043 CEDEX Rennes, France

IJERPH, 2019, vol. 16, issue 21, 1-14

Abstract: Background : Adverse birth outcomes are related to unfavorable fetal growth conditions. A latent variable, named Favorable Fetal Growth Condition (FFGC), has been defined by Bollen et al., in 2013; he showed that this FFGC latent variable mediates the effects of maternal characteristics on several birth outcomes. Objectives : The objectives of the present study were to replicate Bollen’s approach in a population of newborns in Paris and to investigate the potential differential effect of the FFGC latent variable according to the neighborhood socioeconomic level. Methods : Newborn health data were available from the first birth certificate registered by the Maternal and Child Care department of the City of Paris. All newborns (2008–2011) were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level. Several mothers’ characteristics were collected from the birth certificates: age, parity, education and occupational status and the occupational status of the father. Three birth outcomes were considered: birth weight (BW), birth length (BL) and gestational age (GA). Results : Using a series of structural equation models, we confirm that the undirected model (that includes the FFGC latent variable) provided a better fit for the data compared with the model where parental characteristics directly affected BW, BL, and/or GA. However, the strength, the direction and statistical significance of the associations between the exogenous variables and the FFGC were different according to the neighborhood deprivation level. Conclusion: Future research should be designed to assess the how robust the FFGC latent variable is across populations and should take into account neighborhood characteristics to identify the most vulnerable group and create better design prevention policies.

Keywords: adverse birth outcomes; fetal growth conditions; structural equation models (sem); neighborhood deprivation; social inequalities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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