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Maternal Social and Economic Factors and Infant Morbidity, Mortality, and Congenital Anomaly

Are There Associations?

Kosowan, Leanne MSc; Mignone, Javier PhD; Chartier, Mariette PhD; Piotrowski, Caroline PhD

doi: 10.1097/FCH.0000000000000211
Health Equity

Experiences during infancy create durable and heritable patterns of social deprivation and illness producing health disparities. This retrospective cohort study of 71 836 infants from Winnipeg, Manitoba, assessed associations between maternal social and economic factors and infant mortality, morbidity, and congenital anomaly. This study found that newborn and postneonatal hospital readmissions are inversely associated with geography. Additionally, social context, including maternal history of child abuse, is associated with infant postneonatal hospital readmissions. Geography and education are associated with infant mortality. Income was not associated with infant mortality or morbidity following adjustment for social support. Interestingly, congenital anomaly rates are 1.2 times more common among 2 parent families and male infants. Understanding associations between infant health and maternal social and economic factors may contribute to interventions and policies to improve health equity.

Department of Family Medicine (Ms Kosowan) and Department of Community Health Sciences (Drs Chartier, Piotrowski, and Mignone), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Correspondence: Leanne Kosowan, MSc, Department of Family Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, D009-780 Bannatyne Ave, Winnipeg, MB R3T2N2, Canada (

The authors acknowledge the contribution of Brenda Elias, who contributed to the design of this study. The authors acknowledge the Manitoba Centre for Health Policy for use of data contained in the Manitoba Population Research Data Repository under project #2013-001 (HIPC#2012/2013-39). The results and conclusions are those of the author and no official endorsement by the Manitoba Centre for Health Policy, Manitoba Health, or other data providers is intended or should be inferred. Data used in this study are from the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba, and were derived from data provided by Manitoba Health and Healthy Child Manitoba. Financial assistance for this project was received from the Network Environment for Aboriginal Health Research (NEAHR), Manitoba Health Research Council (MHRC), Evelyn Shapiro Award for Health Service Research, and the FGS Special Award. Additional in-kind supports were provided for this project by the Manitoba Metis Federation, Health and Wellness Department. Research was conducted according with prevailing ethical principles and reviewed by an institutional review board. The study obtained access permissions from the MCHP, Health Information Privacy Committee of the Government of Manitoba, Healthy Child Manitoba Office, and the Health Research Ethics Board of the University of Manitoba.

The authors declare no conflict of interest.

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