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Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia

OBJECTIVE: To examine socioeconomic inequalities in birth outcomes among infants born between 2008 and 2018 and assessed trends in inequalities during that period in Colombia, a middle-income country with high levels of inequality emerging from a long internal armed conflict. METHODS: Using birth ce...

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Autores principales: Guarnizo-Herreño, Carol C., Torres, Gabriel, Buitrago, Giancarlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321228/
https://www.ncbi.nlm.nih.gov/pubmed/34324557
http://dx.doi.org/10.1371/journal.pone.0255150
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author Guarnizo-Herreño, Carol C.
Torres, Gabriel
Buitrago, Giancarlo
author_facet Guarnizo-Herreño, Carol C.
Torres, Gabriel
Buitrago, Giancarlo
author_sort Guarnizo-Herreño, Carol C.
collection PubMed
description OBJECTIVE: To examine socioeconomic inequalities in birth outcomes among infants born between 2008 and 2018 and assessed trends in inequalities during that period in Colombia, a middle-income country with high levels of inequality emerging from a long internal armed conflict. METHODS: Using birth certificate data in Colombia, we analysed the outcomes of low birth weight, an Apgar score <7 at 5 minutes after birth and the number of prenatal visits among full-term pregnancies. Maternal education and health insurance schemes were used as socioeconomic position (SEP) indicators. Inequalities were estimated using the prevalence/mean of the outcomes across categories of the SEP indicators and calculating the relative and slope indices of inequality (RII and SII, respectively). RESULTS: Among the 5,433,265 full-term singleton births analysed, there was a slight improvement in the outcomes analysed over the study period (lower low-birth-weight and Apgar<7 prevalence rates and higher number of prenatal visits). We observed a general pattern of social gradients and significant relative (RII) and absolute (SII) inequalities for all outcomes across both SEP indicators. RII and SII estimates with their corresponding CIs revealed a general picture of no significant changes in inequalities over time, with some particular, time-dependent exceptions. When comparing the initial and final years of our study period, inequalities in low birth weight related to maternal education increased while those in Apgar score <7 decreased. Relative inequalities across health insurance schemes increased for the two birth outcomes but decreased for the number of prenatal visits. CONCLUSION: The lack of a consistent improvement in the magnitude of inequalities in birth outcomes over an 11-year period is a worrying issue because it could aggravate the cycle of inequality, given the influence of birth outcomes on health, social and economic outcomes throughout the life course. The findings of our analysis emphasize the importance of policies aimed at providing access to quality education and providing a health care system with universal coverage and high levels of integration.
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spelling pubmed-83212282021-07-31 Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia Guarnizo-Herreño, Carol C. Torres, Gabriel Buitrago, Giancarlo PLoS One Research Article OBJECTIVE: To examine socioeconomic inequalities in birth outcomes among infants born between 2008 and 2018 and assessed trends in inequalities during that period in Colombia, a middle-income country with high levels of inequality emerging from a long internal armed conflict. METHODS: Using birth certificate data in Colombia, we analysed the outcomes of low birth weight, an Apgar score <7 at 5 minutes after birth and the number of prenatal visits among full-term pregnancies. Maternal education and health insurance schemes were used as socioeconomic position (SEP) indicators. Inequalities were estimated using the prevalence/mean of the outcomes across categories of the SEP indicators and calculating the relative and slope indices of inequality (RII and SII, respectively). RESULTS: Among the 5,433,265 full-term singleton births analysed, there was a slight improvement in the outcomes analysed over the study period (lower low-birth-weight and Apgar<7 prevalence rates and higher number of prenatal visits). We observed a general pattern of social gradients and significant relative (RII) and absolute (SII) inequalities for all outcomes across both SEP indicators. RII and SII estimates with their corresponding CIs revealed a general picture of no significant changes in inequalities over time, with some particular, time-dependent exceptions. When comparing the initial and final years of our study period, inequalities in low birth weight related to maternal education increased while those in Apgar score <7 decreased. Relative inequalities across health insurance schemes increased for the two birth outcomes but decreased for the number of prenatal visits. CONCLUSION: The lack of a consistent improvement in the magnitude of inequalities in birth outcomes over an 11-year period is a worrying issue because it could aggravate the cycle of inequality, given the influence of birth outcomes on health, social and economic outcomes throughout the life course. The findings of our analysis emphasize the importance of policies aimed at providing access to quality education and providing a health care system with universal coverage and high levels of integration. Public Library of Science 2021-07-29 /pmc/articles/PMC8321228/ /pubmed/34324557 http://dx.doi.org/10.1371/journal.pone.0255150 Text en © 2021 Guarnizo-Herreño et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Guarnizo-Herreño, Carol C.
Torres, Gabriel
Buitrago, Giancarlo
Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia
title Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia
title_full Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia
title_fullStr Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia
title_full_unstemmed Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia
title_short Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia
title_sort socioeconomic inequalities in birth outcomes: an 11-year analysis in colombia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8321228/
https://www.ncbi.nlm.nih.gov/pubmed/34324557
http://dx.doi.org/10.1371/journal.pone.0255150
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