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Maternal Socioeconomic Mobility and Preterm Delivery: A Latent Class Analysis

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Abstract

Objective Growing evidence suggests that maternal socioeconomic mobility (SM) is associated with pregnancy outcomes. Our study investigated the association between maternal SM from childhood to adulthood and the risk of preterm delivery (PTD), and examined heterogeneity of associations by race/ethnicity. Methods In this study, 3019 pregnant women enrolled from 5 Michigan communities at 16–27 weeks’ gestation (1998–2004) provided their parents’ socioeconomic position (SEP) indicators (education, occupation, receipt of public assistance) and their own and child’s father’s SEP indicators (education, occupation, Medicaid status, and household income) at the time of enrollment. Latent class analysis was used to identify latent classes of childhood SEP indicators, adulthood SEP indicators, and SM from childhood to adulthood, respectively. A model-based approach to latent class analysis with distal outcome assessed relations between latent class and PTD, overall and within race/ethnicity groups. Results Three latent classes (low, middle, high) were identified for childhood SEP indicators and adulthood SEP indicators, respectively; while four latent classes (static low, upward, downward, and static high) best described SM. Women with upward SM had decreased odds of PTD (Odds ratio = 0.60, 95% confidence interval: 0.42, 0.87), compared to those with static low SEP. This SM advantage was true for all women and most pronounced in white/others women. Conclusions Maternal experiences of upward SM may be important considerations when assessing PTD risk. Our results support the argument that policies and programs aimed at improving women’s SEP could lower PTD rates.

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Acknowledgements

Special thanks to members of the POUCH Study Team for their feedback and critique of this manuscript as it was being developed. The POUCH Study was supported by a Perinatal Epidemiologic Research Initiative Program Grant from the March of Dimes Foundation (Grants 20FY01-38 and 20-FY04-37) the National Institute of Child Health and Human Development and the National Institute of Nursing Research (Grant R01 HD34543), the Thrasher Research Foundation (Grant 02816-7) and the Centers for Disease Control and Prevention (Grant U01 DP000143-01).

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Fee Road Room B601, East Lansing, Michigan, 48824, USA

    Yan Tian, Claudia Holzman, Claire Margerison-Zilko, Zhehui Luo & David Todem

  2. College of Nursing and Health Professions, Drexel University, 245 N 15th St, Mailstop 501, Philadelphia, PA, 19102, USA

    Jaime Slaughter-Acey

Authors
  1. Yan Tian
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  2. Claudia Holzman
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  3. Jaime Slaughter-Acey
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  4. Claire Margerison-Zilko
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  5. Zhehui Luo
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  6. David Todem
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Corresponding author

Correspondence to Claudia Holzman.

Appendices

Appendix 1

See Table 5.

Table 5 Fit statistics for latent class analysis (n = 3019), Pregnancy Outcomes and Community Health Study, Michigan, 1998–2004
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Appendix 2

See Table 6.

Table 6 Estimated item-response probabilities of the socioeconomic position indicators conditional on latent class membership with distal outcome preterm delivery overall and by race/ethnicity (n = 3019), Pregnancy Outcomes and Community Health Study, Michigan, 1998–2004
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Appendix 3

See Table 7.

Table 7 Odds ratios of preterm delivery conditional on latent class membership (n = 3019), Pregnancy Outcomes and Community Health Study, Michigan, 1998–2004
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Tian, Y., Holzman, C., Slaughter-Acey, J. et al. Maternal Socioeconomic Mobility and Preterm Delivery: A Latent Class Analysis. Matern Child Health J 22, 1647–1658 (2018). https://doi.org/10.1007/s10995-018-2562-6

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