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Logo of archdischArchives of Disease in ChildhoodInstructions for authorsCurrent TOC
Arch Dis Child. May 2000; 82(5): 349–352.
PMCID: PMC1718336

Socioeconomic inequalities in risk of congenital anomaly

Abstract

AIMS—To investigate socioeconomic inequalities in the risk of congenital anomalies, focusing on risk of specific anomaly subgroups.
METHODS—A total of 858 cases of congenital anomaly and 1764 non-malformed control births were collected between 1986 and 1993 from four UK congenital malformation registers, for the purposes of a European multicentre case control study on congenital anomaly risk near hazardous waste landfill sites. As a measure of socioeconomic status, cases and controls were given a value for the area level Carstairs deprivation index, by linking the postcode of residence at birth to census enumeration districts (areas of approximately 150households).
RESULTS—Risk of non-chromosomal anomalies increased with increasing socioeconomic deprivation. The risk in the most deprived quintile of the deprivation index was 40% higher than in the most affluent quintile. Some malformation subgroups also showed increasing risk with increasing deprivation: all cardiac defects, malformations of the cardiac septa, malformations of the digestive system, and multiple malformations. No evidence for socioeconomic variation was found for other non-chromosomal malformation groups, including neural tube defects and oral clefts. A decreasing risk with increasing deprivation found for all chromosomal malformations and Down's syndrome in unadjusted analyses, occurred mainly as a result of differences in the maternal age distribution between social classes.
CONCLUSION—Our data, although based on limited numbers of cases and geographical coverage, suggest that more deprived populations have a higher risk of congenital anomalies of non-chromosomal origin and some specific anomalies. Larger studies are needed to confirm these findings and to explore their aetiological implications.

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Selected References

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  • Dolk H, Vrijheid M, Armstrong B, Abramsky L, Bianchi F, Garne E, Nelen V, Robert E, Scott JE, Stone D, et al. Risk of congenital anomalies near hazardous-waste landfill sites in Europe: the EUROHAZCON study. Lancet. 1998 Aug 8;352(9126):423–427. [PubMed]
  • Khoury MJ, Weinstein A, Panny S, Holtzman NA, Lindsay PK, Farrel K, Eisenberg M. Maternal cigarette smoking and oral clefts: a population-based study. Am J Public Health. 1987 May;77(5):623–625. [PMC free article] [PubMed]
  • Werler MM. Teratogen update: smoking and reproductive outcomes. Teratology. 1997 Jun;55(6):382–388. [PubMed]
  • Reading R, Raybould S, Jarvis S. Deprivation, low birth weight, and children's height: a comparison between rural and urban areas. BMJ. 1993 Dec 4;307(6917):1458–1462. [PMC free article] [PubMed]
  • Leon DA. Influence of birth weight on differences in infant mortality by social class and legitimacy. BMJ. 1991 Oct 19;303(6808):964–967. [PMC free article] [PubMed]
  • Gray AM. Inequalities in health. The Black Report: a summary and comment. Int J Health Serv. 1982;12(3):349–380. [PubMed]
  • Ericson A, Eriksson M, Zetterström R. The incidence of congenital malformations in various socioeconomic groups in Sweden. Acta Paediatr Scand. 1984 Sep;73(5):664–666. [PubMed]
  • Tuohy PG, Counsell AM, Geddis DC. The Plunket National Child Health Study: birth defects and sociodemographic factors. N Z Med J. 1993 Nov 24;106(968):489–492. [PubMed]
  • Olsen J, Frische G. Social differences in reproductive health. A study on birth weight, stillbirths and congenital malformations in Denmark. Scand J Soc Med. 1993 Jun;21(2):90–97. [PubMed]
  • Lopez PM, Stone D, Gilmour H. Epidemiology of Down's syndrome in a Scottish city. Paediatr Perinat Epidemiol. 1995 Jul;9(3):331–340. [PubMed]
  • Womersley J, Stone DH. Epidemiology of facial clefts. Arch Dis Child. 1987 Jul;62(7):717–720. [PMC free article] [PubMed]
  • Hemminki K, Mutanen P, Luoma K, Saloniemi I. Congenital malformations by the parental occupation in Finland. Int Arch Occup Environ Health. 1980;46(2):93–98. [PubMed]
  • Correa-Villaseñor A, McCarter R, Downing J, Ferencz C. White-black differences in cardiovascular malformations in infancy and socioeconomic factors. The Baltimore-Washington Infant Study Group. Am J Epidemiol. 1991 Aug 15;134(4):393–402. [PubMed]
  • Dolk H, Busby A, Armstrong BG, Walls PH. Geographical variation in anophthalmia and microphthalmia in England, 1988-94. BMJ. 1998 Oct 3;317(7163):905–910. [PMC free article] [PubMed]
  • Carstairs V, Morris R. Deprivation and health in Scotland. Health Bull (Edinb) 1990 Jul;48(4):162–175. [PubMed]
  • Pattenden S, Dolk H, Vrijheid M. Inequalities in low birth weight: parental social class, area deprivation, and "lone mother" status. J Epidemiol Community Health. 1999 Jun;53(6):355–358. [PMC free article] [PubMed]
  • Hook EB, Cross PK. Maternal cigarette smoking, Down syndrome in live births, and infant race. Am J Hum Genet. 1988 Mar;42(3):482–489. [PMC free article] [PubMed]
  • Wasserman CR, Shaw GM, Selvin S, Gould JB, Syme SL. Socioeconomic status, neighborhood social conditions, and neural tube defects. Am J Public Health. 1998 Nov;88(11):1674–1680. [PMC free article] [PubMed]
  • de Walle HE, van der Pal KM, de Jong-van den Berg LT, Schouten J, de Rover CM, Buitendijk SE, Cornel MC. Periconceptional folic acid in The Netherlands in 1995. Socioeconomic differences. J Epidemiol Community Health. 1998 Dec;52(12):826–827. [PMC free article] [PubMed]

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