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Education is the strongest socio-economic predictor of smoking in pregnancy
Stockholm University, Faculty of Social Sciences, Department of Sociology. European University Institute, Italy; University of Turku, Finland.
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Number of Authors: 52018 (English)In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 113, no 6, p. 1117-1126Article in journal (Refereed) Published
Abstract [en]

Aims To investigate socio-economic disparities in smoking in pregnancy (SIP) by the mother's education, occupational class and current economic conditions. Design Cross-sectional analysis with linked survey and register data. Setting South-western Finland. Participants A total of 2667 pregnant women [70% of the original sample (n=3808)] from FinnBrain, a prospective pregnancy cohort study. Measurements The outcome was smoking during the first pregnancy trimester, measured from the Finnish Medical Birth Register. Education and occupational class were linked from population registers. Income support recipiency and subjective economic wellbeing were questionnaire-based measures of current economic conditions. These were adjusted for age, partnership status, residential area type, parental separation, parity, childhood socio-economic background, childhood adversities (the Trauma and Distressing Events During Childhood scale) and antenatal stress (Edinburgh Postnatal Depression Scale). Logistic regressions and attributable fractions (AF) were estimated. Findings Mother's education was the strongest socio-economic predictor of SIP. Compared with university education, adjusted odds ratios (aORs) of SIP were: 2.2 [95% confidence interval (CI)=1.2-3.9; P=0.011] for tertiary vocational education, 4.4 (95% CI=2.1-9.0; P<0.001) for combined general and vocational secondary education, 2.9 (95% CI=1.4-6.1; P=0.006) for general secondary education, 9.5 (95% CI 5.0-18.2; P<0.001) for vocational secondary education and 14.4 (95% CI=6.3-33.0; P<0.001) for compulsory schooling. The total AF of education was 0.5. Adjusted for the other variables, occupational class and subjective economic wellbeing did not predict SIP. Income support recipiency was associated positively with SIP (aOR=1.8; 95% CI=1.1-3.1; P=0.022). Antenatal stress predicted SIP (aOR=2.0; 95% CI=1.4-2.8; P<0.001), but did not attenuate its socio-economic disparities. Conclusions In Finland, socio-economic disparities in smoking in pregnancy are attributable primarily to differences in the mother's educational level (low versus high) and orientation (vocational versus general).

Place, publisher, year, edition, pages
2018. Vol. 113, no 6, p. 1117-1126
Keywords [en]
Attributable fraction, birth cohort, pregnancy, smoking in pregnancy, socio-economic differences, socio-economic status, tobacco smoking, vocational education
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:su:diva-157710DOI: 10.1111/add.14158ISI: 000431958200020PubMedID: 29333764OAI: oai:DiVA.org:su-157710DiVA, id: diva2:1236183
Available from: 2018-07-31 Created: 2018-07-31 Last updated: 2018-07-31Bibliographically approved

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Härkönen, JuhoKarlsson, LinneaKarlsson, Hasse
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