Objective: To determine the socioeconomic gradient of birthweights in England with reference to the prescriptive INTERGROWTH-21 Birthweight Standard.
Design: National cross-sectional study using data from Hospital Episode Statistics.
Setting: National Health Service in England.
Participants: All singleton babies, live born between 34 weeks' gestation and 42 weeks' gestation, between 1 April 2011 and 31 March 2012.
Main Outcome Measures: Birthweight distribution of babies with a birthweight of <10th centile or >90th centile, that is, small for gestational age (SGA) or large for gestational age (LGA) using Index of Multiple Deprivation quintiles as a proxy for socioeconomic status.
Results: Of 508 230 babies born alive between 1 April 2011 and 31 March 2012, 38 838 (7.6%) were SGA and 81 026 (15.9%) were LGA. Median birthweight was 3405 g, median z-score was 0.25 (SD 1.06). Birthweight z-score demonstrated a social gradient, from 0.26 (SD 1.1) in the most deprived areas to 0.53 (1.0) in the least deprived. Women in the most deprived areas were twice as likely to have SGA babies using the INTERGROWTH-21 chart (OR 1.94; 95% CI 1.87 to 2.01) compared with those in the least deprived areas. If all women had the same rate of SGA equivalent to those living in the least deprived areas, approximately 12 410 (30%) fewer babies would be born SGA in England each year.
Conclusions: This study gives a measure of the social gradient in singleton SGA and LGA babies across England using an international standard of newborn size at birth.
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http://dx.doi.org/10.1136/archdischild-2018-315295 | DOI Listing |
Gut
January 2025
Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK
Background: Low-dose amitriptyline, a tricyclic antidepressant (TCA), was superior to placebo for irritable bowel syndrome (IBS) in the AmitripTyline at Low-dose ANd Titrated for Irritable bowel syndrome as Second-line treatment (ATLANTIS) trial.
Objective: To perform post hoc analyses of ATLANTIS for predictors of response to, and tolerability of, a TCA.
Design: ATLANTIS randomised 463 adults with IBS to amitriptyline (232) or placebo (231).
Int J Cancer
January 2025
Inequalities in Cancer Outcomes Network (ICON) group, Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
We aimed to investigate socio-economic inequalities in second primary cancer (SPC) incidence among breast cancer survivors. Using Data from cancer registries in England, we included all women diagnosed with a first primary breast cancer (PBC) between 2000 and 2018 and aged between 18 and 99 years and followed them up from 6 months after the PBC diagnosis until a SPC event, death, or right censoring, whichever came first. We used flexible parametric survival models adjusting for age and year of PBC diagnosis, ethnicity, PBC tumour stage, comorbidity, and PBC treatments to model the cause-specific hazards of SPC incidence and death according to income deprivation, and then estimated standardised cumulative incidences of SPC by deprivation, taking death as the competing event.
View Article and Find Full Text PDFInt J Environ Res Public Health
December 2024
Faculty of Health Sciences, School of Public Health, The University of Cape Town, Cape Town 7925, South Africa.
Under-five child poverty and income inequality are complex socio-economic phenomena that significantly impact the well-being of children worldwide. While there is a growing body of literature addressing child poverty in South Africa, our understanding of settlement discrepancies and factors influencing multidimensional under-five child poverty and income in the country remains limited. This study assesses under-five-specific multidimensional poverty and the determinates of child poverty and inequality in the lowest geographical areas in South Africa.
View Article and Find Full Text PDFLancet Child Adolesc Health
February 2025
University College London Great Ormond Street Institute of Child Health, London, UK.
Background: There are challenges in providing high quality care for children and young people who are admitted to acute medical wards for mental health concerns. Although there is concern that these admissions are increasing, national data describing these patterns are scarce. We aimed to describe trends in these admissions in England over a 10-year period, and to identify factors associated with repeat admission and length of stay.
View Article and Find Full Text PDFEur J Emerg Med
January 2025
Université Paris Cité, ECEVE, UMR 1123 Unit, Inserm.
Background And Importance: Access to healthcare remains a persistent challenge. Socially disadvantaged populations often encounter barriers to care and may frequently seek out emergency departments (EDs), including for nonurgent medical care.
Objective: The objective of this study is to study the association between nonurgent presentations to pediatric EDs and patients' socioeconomic environment in an urban setting.
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