Examining the Association Between Parental Socioeconomic Status and Preterm Birth Using Multidomain Social Determinants Scale in a Tertiary Care Center in Saudi Arabia

Mohammed Y Al-Hindi; Hazem Aljuhani; Anas R Alnajjar; Sarah Alessa; Mansour Alqurashi; Yaser A Faden

doi:10.7759/cureus.10506

Examining the Association Between Parental Socioeconomic Status and Preterm Birth Using Multidomain Social Determinants Scale in a Tertiary Care Center in Saudi Arabia

Cureus. 2020 Sep 17;12(9):e10506. doi: 10.7759/cureus.10506.

Authors

Mohammed Y Al-Hindi^{1

2

3}, Hazem Aljuhani², Anas R Alnajjar², Sarah Alessa⁴, Mansour Alqurashi^{1

2

3}, Yaser A Faden^{5

2

3}

Affiliations

¹ Pediatrics, King Abdulaziz Medical City - Western Region, Ministry of National Guard, Jeddah, SAU.
² College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.
³ Research and Development, King Abdullah International Medical Research Center - Western Region, Jeddah, SAU.
⁴ College of Medicine, King Abdulaziz University Hospital, Jeddah, SAU.
⁵ Obstetrics and Gynecology, King Abdulaziz Medical City - Western Region, Ministry of National Guard, Jeddah, SAU.

Abstract

Objectives Socioeconomic status (SES) plays a conflicting role in preterm birth (PB). This study evaluated the association between SES and PB using, for the first time, a multidomain scale, validated for Saudi Arabia, with a scoring system and examined the effect of each SES domain on PB. The secondary outcome was to determine the effects of SES on birth weight (BW) and the subcategories of PB and BW. Methods This cross-sectional study was conducted between May 2017 and August 2017 at a National Guard tertiary center in Jeddah, Saudi Arabia. A total of 477 parents were interviewed using the Elzahrany R. SES scale. Results The rate of PB was 11.5%, with no significant differences among the high, middle, and low SES classes (13%, 11%, and 12.5%, respectively). There were no patients in the very low SES in this specific population. None of the maternal or neonatal characteristics were significantly different among SES classes except maternal age (p value = 0.03), and antenatal care recorded visits "booking" status (p value = 0.012). Stratified analysis for PB subcategories showed the lower SES classes had higher moderate (3.8%) and extreme (1.6%) PB. For BW subcategories, large for gestational age (LGA) infants were higher in the high SES class (13%). However, the lower SES classes had higher rates of lower BW. The association between SES and PB remained not significant after adjusting for the maternal age and antenatal booking status. Conclusion There was no association between SES and PB at a tertiary center providing universal care to the National Guard using multidomain socioeconomic determinants with a scoring system. However, lower SES was associated with lower BW. The use of the "polysocial risk score" based on locally validated surveys should be considered in any health research that examines the effects of socioeconomic determinants.

Keywords: birth weight; multidomain scale; polysocial risk score; preterm birth; preterm delivery; socioeconomic factors; socioeconomic status.