Associations Between Socioeconomic Status and Adverse Pregnancy Outcomes: A Greater Magnitude of Perinatal Inequities in Montreal Than in Brussels



Objective This paper compares the associations between socioeconomic status (SES) and 1) low birth weight (LBW) and 2) preterm birth, in Brussels and Montreal, and discusses hypotheses that may explain the differences between these two regions.  

Methods This population-based study uses administrative databases from Belgian and Quebec birth records. The analysis is based on 97,844 and 214,620 singleton live births in Brussels and Montreal, respectively. Logistic regression models were developed for each region in order to estimate the relationship between SES (maternal education and income quintile) and pregnancy outcomes. The analyses were performed for all births according to the mother’s origin.  

Results SES is associated with LBW and preterm birth in both regions. This association varies according to the mother’s birth place; the impact of SES being greater for mothers born in Belgium or Canada than for those born abroad. The main difference between the two regions concerns the magnitude of perinatal inequalities, which is greater in Montreal than in Brussels, whether among the general population, native-born mothers, or immigrant mothers.  

Conclusion Significant differences in social inequalities in perinatal health are observed between Brussels and Montreal. The different characteristics of low-income and immigrant households between the two contexts help explain these results. In fact, the poor are relatively poorer in Quebec than in Belgium and live in a more unequal context.

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