ArticlePloS one2013
Malaria infection, poor nutrition and indoor air pollution mediate socioeconomic differences in adverse pregnancy outcomes in Cape Coast, Ghana.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 25 papers, 2 of them syntheses that pooled it.
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25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Mediators of socioeconomic inequalities in preterm birth: a systematic review.BMC public health · 2022Pooled it
- Burden and determinants of malnutrition among pregnant women in Africa: A systematic review and meta-analysis.PloS one · 2019Pooled it
- Ambient temperature, rainfall, and adverse maternal and child health outcomes in Nigeria: evidence from a national cross-sectional study.Frontiers in public health · 2026Article
- Sociodemographic and socioeconomic predictors of asymptomatic malaria among children and adolescents in rural Guinea: a longitudinal study.Frontiers in public health · 2026Article
- Mediating role of gestational weight gain in the relationship between socioeconomic status and preterm birth: a Chinese population-based study.BMC public health · 2024Article
- The effects of inhaled pollutants on reproduction in marginalized communities: a contemporary review.Inhalation toxicology · 2024Review
- Metabolic hormones are integral regulators of female reproductive health and function.Bioscience reports · 2024Review
- An evolutionary perspective on social inequality and health disparities: Insights from the producer-scrounger game.Evolution, medicine, and public health · 2023Article
- Educational attainment and offspring birth weight: A bidirectional Mendelian randomization study.Frontiers in genetics · 2022Article
- Socio-economic and household determinants of malaria in adults aged 45 and above: analysis of longitudinal ageing survey in India, 2017-2018.Malaria journal · 2021Article
- Association of Traumatic Injury With Adverse Pregnancy Outcomes in Taiwan, 2004 to 2014.JAMA network open · 2021Article
- Changing Patterns in Epidemiology of Malaria Between 2006 and 2018 in the South of Fars Province, Southern Iran: The Fall and Rise of Malaria.Annals of global health · 2020Article
- Combined Impacts of Prenatal Environmental Exposures and Psychosocial Stress on Offspring Health: Air Pollution and Metals.Current environmental health reports · 2020Review
- A review of maternal prenatal exposures to environmental chemicals and psychosocial stressors-implications for research on perinatal outcomes in the ECHO program.Journal of perinatology : official journal of the California Perinatal Association · 2020Review
- Stigma toward small babies and their mothers in Ghana: A study of the experiences of postpartum women living with HIV.PloS one · 2020Article
- Equity in maternal health outcomes in a middle-income urban setting: a cohort study.Reproductive health · 2019Article
- Article
- Article
- CHILDHOOD RESPIRATORY MORBIDITY AND COOKING PRACTICES AMONG HOUSEHOLDS IN A PREDOMINANTLY RURAL AREA OF GHANA.African journal of infectious diseases · 2016Article
- Motivations for food prohibitions during pregnancy and their enforcement mechanisms in a rural Ghanaian district.Journal of ethnobiology and ethnomedicine · 2015Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe epidemiological evidence linking socioeconomic deprivation with adverse pregnancy outcomes has been conflicting mainly due to poor measurement of socioeconomic status (SES). Studies have also failed to evaluate the plausible pathways through which socioeconomic disadvantage impacts on pregnancy outcomes. We investigated the importance of maternal SES as determinant of birth weight and gestational duration in an urban area and evaluated main causal pathways for the influence of SES.
methodsA population-based cross-sectional study was conducted among 559 mothers accessing postnatal services at the four main health facilities in Cape Coast, Ghana in 2011. Information on socioeconomic characteristics of the mothers was collected in a structured questionnaire.
resultsIn multivariate linear regression adjusting for maternal age, parity and gender of newborn, low SES resulted in 292 g (95% CI: 440-145) reduction in birth weight. Important SES-related determinants were neighborhood poverty (221 g; 95% CI: 355-87), low education (187 g; 95% CI: 355-20), studentship during pregnancy (291 g; 95% CI: 506-76) and low income (147 g; 95% CI: 277-17). In causal pathway analysis, malaria infection (6-20%), poor nutrition (2-51%) and indoor air pollution (10-62%) mediated substantial proportions of the observed effects of socioeconomic deprivation on birth weight. Generalized linear models adjusting for confounders indicated a 218% (RR: 3.18; 95% CI: 1.41-7.21) risk increase of LBW and 83% (RR: 1.83; 95% CI: 1.31-2.56) of PTB among low income mothers. Low and middle SES was associated with 357% (RR: 4.57; 95% CI: 1.67-12.49) and 278% (RR: 3.78; 95% CI: 1.39-10.27) increased risk of LBW respectively. Malaria infection, poor nutrition and indoor air pollution respectively mediated 10-21%, 16-44% and 31-52% of the observed effects of socioeconomic disadvantage on LBW risk.
conclusionWe provide evidence of the effects of socioeconomic deprivation, substantially mediated by malaria infection, poor nutrition and indoor air pollution, on pregnancy outcomes in a developing country setting.
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