Health inequalities at birth within the Hungarian 2018–2019 birth cohort: socioeconomic determinants of low birth weight infants
Abstract
Objective: Low birth weight (LBW) is a significant global factor linked to numerous health risks, both in early life and extending into adulthood. Our analysis estimates how maternal education and other socioeconomic status characteristics influence the risk of low birth weight in Hungary.
Methods: The source of the data is the Cohort ’18 Growing up in Hungary longitudinal birth cohort survey. The nationally representative sample of 10 per cent includes women who gave birth to a child between spring 2018-2019. Data from 8183 women are analysed, excluding twin pregnancies. Generalized structural equation modelling (GSEM) was used to examine the magnitude of the direct and indirect association between maternal education and low birth weight (LBW), through additional socioeconomic status (SES) characteristics of the mother such as household income, occupational status, ethnic background and place of residence, controlling for key biological, demographic, health and lifestyle characteristics of mother and child.
Results: Women with up to 8th grade education are three times more likely to have a low birth weight child than women with tertiary education (11.8 per cent vs. 3.6 per cent), but they are also significantly more likely to have a low birth weight child than either women with vocational education (6.8 per cent) or women with secondary education (4.4 per cent). When the direct and indirect relationships between maternal education, other SES indicators and LBW are considered, the share of direct effect between maternal education and having a low birth weight child is 73 per cent of the total effect, while the indirect effect is 27 per cent of the total effect. This is the proportion of the combined indirect effect of household income, occupational status, Roma ethnic background and place of residence relative to the total effect. Of these, the indirect effect of educational attainment measured through household income is the largest, at 26 per cent of the total effect.
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