Letters

From the former Soviet Union: Maternal education seems to determine pregnancy outcomes in Russia

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.331.7510.236 (Published 21 July 2005) Cite this as: BMJ 2005;331:236
  1. Andrej M Grjibovski, post-doctoral research fellow (andrej.grjibovski{at}prevnut.ki.se),
  2. Lars Olov Bygren, professor emeritus
  1. Division of Epidemiology, Norwegian Institute of Public Health, Post box 4404 Nydalen, 0403 Oslo, Norway
  2. Department of Biosciences at Novum, Karolinska Institutet, 14157 Huddinge, Sweden

    EDITOR—Social resilience is the ability of human communities to withstand and recover from external shocks or disturbances to their infrastructure. The countries of the former Soviet Union seem to have been more vulnerable to the recent political, economic, and social changes than the countries of central Europe, which are showing signs of recovery from the crisis.

    Although the changes have been more profound in the former Soviet republics than in central Europe, social determinants of health in the former Soviet countries have received less attention. For example, no studies on socioeconomic determinants of maternal and child health based on Russian data have been published in international, peer reviewed journals.


    Embedded Image

    Maternal factors strongly influence pregnancy outcomes in Russia

    Credit: JAMES NUBILE/THE IMAGEWORKS/REX

    We studied social determinants of pregnancy outcomes and infant growth in Severodvinsk, a town in northwest Russia, one of the regions that have suffered most since 1990.1 All 1559 pregnant women registered at municipal antenatal clinics during 1999 were enrolled in a cohort and followed through delivery. Their infants were followed up during the first year of life.

    Social variations in birth weight2 and preterm birth rates3 were among the largest in Europe. Maternal education was the most important social factor influencing pregnancy outcomes in the area, even after suspected explanatory mechanisms were included in the analyses. Poor housing conditions, stress, and smoking also influenced fetal growth indices.4 Variations in linear growth of infants by maternal education tended to increase during the first year of life.5

    Evidence of the existence of social inequalities in health is an important first step towards addressing these problems. It advocates the development of policies designed to reduce these inequalities. From a scientific perspective, larger, well designed studies are needed to reveal the mechanisms behind the large social disparities in pregnancy outcomes in Russia.

    Footnotes

    • A full text copy of the thesis by AMG, entitled “Sociodemographic determinants of pregnancy outcomes and infant growth in transitional Russia,” is available by emailing him.

    • Competing interests None declared.

    References

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