Cargando…

A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms

Scientific literature tends to support the idea that the pregnancy and health status of fetuses and newborns can be affected by maternal, parental, and contextual characteristics. In addition, a growing body of evidence reports that social determinants, measured at individual and/or aggregated level...

Descripción completa

Detalles Bibliográficos
Autores principales: Simoncic, Valentin, Deguen, Séverine, Enaux, Christophe, Vandentorren, Stéphanie, Kihal-Talantikite, Wahida
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9779203/
https://www.ncbi.nlm.nih.gov/pubmed/36554473
http://dx.doi.org/10.3390/ijerph192416592
_version_ 1784856552317911040
author Simoncic, Valentin
Deguen, Séverine
Enaux, Christophe
Vandentorren, Stéphanie
Kihal-Talantikite, Wahida
author_facet Simoncic, Valentin
Deguen, Séverine
Enaux, Christophe
Vandentorren, Stéphanie
Kihal-Talantikite, Wahida
author_sort Simoncic, Valentin
collection PubMed
description Scientific literature tends to support the idea that the pregnancy and health status of fetuses and newborns can be affected by maternal, parental, and contextual characteristics. In addition, a growing body of evidence reports that social determinants, measured at individual and/or aggregated level(s), play a crucial role in fetal and newborn health. Numerous studies have found social factors (including maternal age and education, marital status, pregnancy intention, and socioeconomic status) to be linked to poor birth outcomes. Several have also suggested that beyond individual and contextual social characteristics, living environment and conditions (or “neighborhood”) emerge as important determinants in health inequalities, particularly for pregnant women. Using a comprehensive review, we present a conceptual framework based on the work of both the Commission on Social Determinants of Health and the World Health Organization (WHO), aimed at describing the various pathways through which social characteristics can affect both pregnancy and fetal health, with a focus on the structural social determinants (such as socioeconomic and political context) that influence social position, as well as on intermediary determinants. We also suggest that social position may influence more specific intermediary health determinants; individuals may, on the basis of their social position, experience differences in environmental exposure and vulnerability to health-compromising living conditions. Our model highlights the fact that adverse birth outcomes, which inevitably lead to health inequity, may, in turn, affect the individual social position. In order to address both the inequalities that begin in utero and the disparities observed at birth, it is important for interventions to target various unhealthy behaviors and psychosocial conditions in early pregnancy. Health policy must, then, support: (i) midwifery availability and accessibility and (ii) enhanced multidisciplinary support for deprived pregnant women.
format Online
Article
Text
id pubmed-9779203
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-97792032022-12-23 A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms Simoncic, Valentin Deguen, Séverine Enaux, Christophe Vandentorren, Stéphanie Kihal-Talantikite, Wahida Int J Environ Res Public Health Review Scientific literature tends to support the idea that the pregnancy and health status of fetuses and newborns can be affected by maternal, parental, and contextual characteristics. In addition, a growing body of evidence reports that social determinants, measured at individual and/or aggregated level(s), play a crucial role in fetal and newborn health. Numerous studies have found social factors (including maternal age and education, marital status, pregnancy intention, and socioeconomic status) to be linked to poor birth outcomes. Several have also suggested that beyond individual and contextual social characteristics, living environment and conditions (or “neighborhood”) emerge as important determinants in health inequalities, particularly for pregnant women. Using a comprehensive review, we present a conceptual framework based on the work of both the Commission on Social Determinants of Health and the World Health Organization (WHO), aimed at describing the various pathways through which social characteristics can affect both pregnancy and fetal health, with a focus on the structural social determinants (such as socioeconomic and political context) that influence social position, as well as on intermediary determinants. We also suggest that social position may influence more specific intermediary health determinants; individuals may, on the basis of their social position, experience differences in environmental exposure and vulnerability to health-compromising living conditions. Our model highlights the fact that adverse birth outcomes, which inevitably lead to health inequity, may, in turn, affect the individual social position. In order to address both the inequalities that begin in utero and the disparities observed at birth, it is important for interventions to target various unhealthy behaviors and psychosocial conditions in early pregnancy. Health policy must, then, support: (i) midwifery availability and accessibility and (ii) enhanced multidisciplinary support for deprived pregnant women. MDPI 2022-12-10 /pmc/articles/PMC9779203/ /pubmed/36554473 http://dx.doi.org/10.3390/ijerph192416592 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Simoncic, Valentin
Deguen, Séverine
Enaux, Christophe
Vandentorren, Stéphanie
Kihal-Talantikite, Wahida
A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms
title A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms
title_full A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms
title_fullStr A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms
title_full_unstemmed A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms
title_short A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms
title_sort comprehensive review on social inequalities and pregnancy outcome—identification of relevant pathways and mechanisms
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9779203/
https://www.ncbi.nlm.nih.gov/pubmed/36554473
http://dx.doi.org/10.3390/ijerph192416592
work_keys_str_mv AT simoncicvalentin acomprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT deguenseverine acomprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT enauxchristophe acomprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT vandentorrenstephanie acomprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT kihaltalantikitewahida acomprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT simoncicvalentin comprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT deguenseverine comprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT enauxchristophe comprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT vandentorrenstephanie comprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms
AT kihaltalantikitewahida comprehensivereviewonsocialinequalitiesandpregnancyoutcomeidentificationofrelevantpathwaysandmechanisms