The influence of maternal childhood and adulthood social class on the health of her infant: larger differences closer to birth

The general objective was to investigate how maternal childhood and adulthood social class contribute to social inequalities in low birth weight, neonatal mortality and postneonatal mortality, particularly the combined influence of childhood and adult class and a comparison of influence on outcomes with regard to time distance from birth. Analyses were performed on a large sample of Swedish births 1973-1990, restricted to infants of women with childhood and adult class classified as manual or non-manual. Logistic regression was used to compare odds ratios for social classes. The results indicated that manual maternal childhood class was consistently associated with higher risks for low birth weight and neonatal mortality, even when adult class was adjusted for. Influence of adult class was larger than that of childhood class on all health outcomes. Compared to higher/middle non-manuals, unskilled workers in the service sector and workers in the manufacturing sector displayed the highest odds ratios for all health outcomes. When we studied class trajectories in which both childhood and adult class were taken into account, social differences were larger for low birth weight and neonatal mortality than postneonatal mortality. Maternal childhood class had more influence on low birth weight and neonatal mortality than on postneonatal mortality. We concluded that maternal childhood and adulthood social class were both independently associated with inequalities in health-related birth outcomes, and that social differences were larger for health outcomes closer to birth.