Socioeconomic Status as Correlate of Obstetric and Delivery-Related Complications: Register-Based Evidence from Spain

Marta Seiz , Spanish National Research Council (CSIC)
Marco Cozzani, University of Firenze
Nerea Bello Iglesias, Universidad Nacional de Educación a Distancia

Despite the quality of healthcare systems in high income countries, adverse pregnancy outcomes and suboptimal maternal health conditions are still not infrequent (Baron et al., 2015; Granés et al., 2023). Their occurrence has been linked to social inequalities affecting maternal health during pregnancy and delivery, since the capacity to access healthcare and to maintain a healthy lifestyle can vary across population groups. In the case of Spain, while there is a growing body of register-based research on outcomes related to the health of the newborn, the impact of socioeconomic variables on obstetric complications has received less attention using population-level data. This study analyzes the relation between socioeconomic status (SES) – measured through occupational status and educational level – and several adverse pregnancy outcomes (stillbirth, infant death within the first 24 hours of life, need for delivery through cesarean section, and complications during delivery; multiplicity is also considered due to its frequent association with complications during gestation and birth). It draws on a sample of 5,551,059 women giving birth between 2007 and 2019 from the Spanish Statistical Bulletin of Births (National Statistics Institute). Results from logistic regression models show that women in low-level occupations, in situations of inactivity, or with less than compulsory education are more likely to experience stillbirth, infant death before 24 hours of birth, delivery complications, and birth by cesarean section. These findings underscore the importance of reinforcing pregnancy surveillance for socioeconomically vulnerable populations and of further work that sheds light on the mechanisms underlying obstetric disadvantage.

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 Presented in Session P3. Families, Fertility, and the Life Course 3