Socio-economic status and risk of congenital malformations

Socio-economic status and risk of congenital malformations 
Objective: to investigate the relationship between socioeconomic factors and the prevalence at birth of a selected group of congenital malformations (CM): neural tube defects (NTD), orofacial clefts (OFC), Down syndrome (DS), renal and urinary anomalies, limb reduction defects and eye anomalies.
Design: matched case-control study (1:1). The aim of the study was to compare the parental socio-economic status of children affected by one of the selected congenital malformations with an appropriate control group, using a synthetic socio-economic indicator. Socioeconomic measures included maternal and paternal education and employment.
Setting: Delivery certificate database from Italian regions, years 2002-2005.
Main outcome measures: odds ratio (OR) measuring the association between the presence at birth of specific CMs and socioeconomic factors, estimated through logistic regression models adjusted for maternal age.
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Preliminary results: the study showed a higher risk for NTD (OR 2,73; 95%  CI 1,36 – 5,50) and OFC (OR 1,18; 95% CI 1,05-1,33) for parents in a low social class. As well, the estimated risk of DS is slightly higher, though not statistically significant (OR 1,08; 95% CI 0,98-1,19). Among the socio-economic variables taken into consideration, the mother’s education level represented a significant risk factor associated with OFC occurrence.
Conclusion: the results suggested that the socioeconomic level may represent a selective risk factor for specific CMs, confirming the role that social inequalities have on health, in particular on reproductive health. Such evidences should be considered when programming specific actions aimed at preventing congenital malformations.