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Socioeconomic disparities in preterm birth and birth weight in a non-Western developed setting: evidence from Hong Kong's ‘Children of 1997’ birth cohort
  1. June Y Y Leung1,
  2. Gabriel M Leung1,
  3. C Mary Schooling1,2
  1. 1School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
  2. 2City University of New York School of Public Health and Health Policy, New York, USA
  1. Correspondence to Dr C Mary Schooling, Li Ka Shing Faculty of Medicine, School of Public Health, The University of Hong Kong. G/F Patrick Manson Building (North Wing), 7 Sassoon Road, Hong Kong, Hong Kong; cms1{at}


Background Preterm birth (PTB), low birth weight and small-for-gestational age (SGA) are associated with lower socioeconomic position (SEP) in developed Western settings, but it is unclear if such disparities persist to the same extent elsewhere, and whether associations differ by measure of SEP used. Here, we assessed the association of SEP with PTB, birth weight and SGA in the recently developed non-Western setting of Hong Kong where few women smoke or use alcohol.

Methods We used multivariable logistic and linear regression to assess the associations of parental and neighbourhood SEP with PTB, birth weight and SGA among 8173 singleton births from the Hong Kong population-representative ‘Children of 1997’ birth cohort.

Results The only measure of SEP associated with PTB was type of housing adjusted for maternal age (p for trend 0.046). Highest paternal education had a small positive association with birth weight adjusted for gestational age (21 g, 95% CI 0.2 to 43 g for ≥grade 12 compared with ≤grade 9), as did residing in private compared with public housing (21 g, 95% CI 3 to 39 g). However, these associations did not persist after adjusting for mother's age. Lower neighbourhood Gini coefficient adjusted for mother's age was associated with a lower risk of SGA (OR 0.78, 95% CI 0.63 to 0.98). None of these associations remained after adjusting for multiple comparisons.

Conclusions PTB, birth weight and SGA may be less clearly socially patterned in Hong Kong than other developed settings, highlighting the need for setting-specific interventions to prevent adverse birth outcomes.

  • Cohort studies

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  • Contributors JYYL and CMS made substantial contributions to the conception and design of this study. JYYL analysed and interpreted the data. GML and CMS made substantial contributions to the conception and design of the original study and the interpretation of data. CMS had substantial contributions to the interpretation of data. JYYL drafted the article, and the other authors reviewed it critically for important intellectual content. All authors gave final approval of the version to be published and agree to be responsible for the reported research.

  • Funding This work is a substudy of the ‘Children of 1997’ birth cohort, which was initially supported by the Health Care and Promotion Fund, Government of the Hong Kong SAR (HCPF Grant # 216106), and re-established in 2005 funded by the Health and Health Services Research Fund, Government of the Hong Kong SAR (HHSRF Grant # 03040771). This substudy was also supported by the Research Fund for the Control of Infectious Diseases, Government of Hong Kong SAR (RFCID Grant # 04050172).

  • Competing interests None declared.

  • Ethics approval Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster.

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