Social variations in fetal growth in a Russian setting: An analysis of medical records

PURPOSE: The study examines variations in fetal growth by maternal social circumstances in a Russian town. METHODS: All pregnant women registered at the antenatal clinics in 1999 in Severodvinsk (northwest Russia) and their live born infants comprised the study base (n = 1399). Multivariate linear regression analysis was applied to quantify the effect of socio-demographic factors on birthweight and the ponderal index (PI). RESULTS: A clear gradient of birthweight in relation to mothers' education was revealed. Babies of the most educated mothers were 207g (95% Cl, 55, 358) heavier than babies of mothers with basic education. The average weight of those born to mothers with secondary and vocational levels of education was 172g (95% Cl, 91, 253) and 83g (95% Cl, 9, 163) lower compared with infants born to mothers with a university level of education after adjustment for age, parity, pre-pregnancy weight, marital status, maternal occupation, length of gestation, and sex of the baby. Maternal education also influenced the PI. CONCLUSIONS: Further studies should focus on the mechanisms of the coherence of maternal education and fetal growth. To ensure that all parts of the society benefit equally from economic and social reforms, social variations in pregnancy outcomes should be monitored during the time of transition. (C) 2003 Elsevier Inc. All rights reserved.