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A comparative study of educational inequality in the risk of stillbirth in Denmark, Finland, Norway and Sweden 1981–2000
  1. Ane L Rom1,
  2. Laust H Mortensen1,2,
  3. Sven Cnattingius3,
  4. Annett Arntzen4,
  5. Mika Gissler5,6,
  6. Anne-Marie Nybo Andersen2,7
  1. 1National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
  2. 2Division of Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, Denmark
  3. 3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  4. 4Faculty of Social Science, Vestfold University, Tønsberg, Norway
  5. 5National Institute for Health and Welfare, Helsinki, Finland
  6. 6Nordic School of Public Health, Gothenburg, Sweden
  7. 7Department of Public Health, University of Copenhagen, Denmark
  1. Correspondence to Professor Anne-Marie Nybo Andersen, Department of Public Health, University of Copenhagen, Oster Farimagsgade 5, P.O. Box 2099 DK-1014 Copenhagen, Denmark; amny{at}sund.ku.dk

Abstract

Background The stillbirth rates in Denmark, Finland, Norway and Sweden are among the lowest in the world, but socioeconomic disparities in stillbirth still exist. This study examined the educational patterns in the risk of stillbirth in Denmark, Finland, Norway and Sweden from 1981 to 2000.

Methods From the national birth registries, all singleton live births and stillbirths with a gestational age of at least 28 weeks were selected in Denmark (n=1 182 888), Finland (n=419 729), Norway (n=1 006 767) and Sweden (n=1 974 101). The births were linked with individual data on parental socioeconomic factors from various national registers. Linear and logistic regression were used to calculate RR and risk differences for stillbirth according to maternal educational attainment.

Results The risk of stillbirth was lowest in Finland and highest in Denmark. The risk decreased over time in Denmark, Norway and Finland, but remained stable in Sweden. Educational gradients were found in all countries in all time periods under study. In Denmark, the gradient remained stable over time. In Norway the gradient decreased slightly during the 1990s, whereas the gradient increased in Sweden. The gradient in Finland was relatively stable.

Conclusions There were persisting educational inequalities in stillbirth in Denmark, Finland, Norway and Sweden in the 1980s and 1990s. Inequalities were stable or decreasing except in Sweden, where an increase in inequality was observed. This increase was not solely attributable to a decreasing absolute risk of stillbirth as both the relative and absolute measures of inequality increased.

  • Comparative study
  • Nordic countries
  • perinatal epidemiology
  • social epidemiology
  • socioeconomic factors
  • stillbirth

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Footnotes

  • Funding This study was supported by a grant from the NordForsk Research Programme on longitudinal epidemiology, which is supported by the Nordic Council of Ministers.

  • Competing interests None.

  • Ethical approval The project was approved by the Danish Data Protection Agency according to Danish legislation.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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