Prenatal subjective social status and birth weight

Abstract

Purpose

Subjective social status (SSS), perceived social standing relative to others, has been associated with health status, independent of objective socioeconomic status (SES). Few studies have examined the relationship of prenatal maternal SSS with birth outcomes. We evaluated the association of SSS in pregnancy with low birth weight (LBW) and high birth weight (HBW).

Methods

A total of 378 pregnant women rated their SSS from 1 (low) to 10 (high) compared to others in the United States (SSS-US) and compared to their community (SSS-Comm). Multivariable logistic regression was used to examine the relationship between SSS and odds of LBW or HBW.

Results

Higher SSS-US was associated with lower odds of HBW in unadjusted models (OR 0.76, 95% CI 0.60–0.96; p < 0.05); this relationship persisted after controlling for objective SES, health, and demographic factors (OR 0.73, 95% CI 0.53–0.99; p < 0.05). Neither SSS measure was associated with LBW.

Conclusions

Pregnant women who view themselves as having lower status than others in the US have greater odds of HBW, over and above the influence of factors known to be associated with birth weight. SSS, a brief and non-stigmatizing measure, might help identify women at elevated social risk for adverse birth outcomes.

Keywords:

• Perinatal epidemiology
• pregnancy
• psychological well-being
• stress
• obstetrics

Acknowledgements

The authors gratefully acknowledge Dr. Neil Goldenberg for his contributions to the PREDICT cohort.

Disclosure statement

The authors do not report any financial conflicts of interest.

Additional information

Funding

This study was supported by a grant from the All Children’s Hospital Foundation and by NIH R01MD011746 (SBJ). DKG was supported by the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number TL1 TR003100 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of the Johns Hopkins ICTR, NCATS, or NIH.