Area-level deprivation as a risk factor for stillbirth in upper-middle and high-income countries: A scoping review

IF 2.6 3区医学 Q1 NURSING

Midwifery Pub Date : 2025-02-01 DOI:10.1016/j.midw.2024.104251

Jessica V. Keane , Laura A. Robinson , Richard A. Greene , Paul Corcoran , Sara Leitao

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引用次数: 0

Abstract

Background

Socioeconomic deprivation has been associated with health inequalities and poor perinatal outcomes. Deprivation is described as a multidimensional concept, with composite indicators (e.g. area-based) developed internationally to study population health.

Aim

This scoping review aims to examine published literature on the relationship between area-level deprivation and stillbirth in upper-middle to high-income countries.

Methods

The Joanna Briggs Institute methodology for scoping reviews was utilised. The research question based on the Population (studies that examined stillbirth) Concept (area-level deprivation and its impact on stillbirth) Context (upper-middle- to high-income countries) framework. Six scientific databases were searched. Results were screened and reference lists searched to identify relevant literature. Data extraction on study characteristics and evidence of association provided was completed and a narrative summary reported the main findings.

Results

A total of 29 studies were included, from 9 countries (majority UK-based: n = 20) published between 1998 and 2023. A variety of composite deprivation indices were utilised, the UK's Index of Multiple Deprivation (IMD) was the most common (n = 8), followed by the Townsend and Jarman indices (n = 6 and n = 3, respectively). Income, employment, education and access to services were the most common factors included as measures of deprivation in the indices. Twenty-two of the 29 studies (75.9%) showed positive correlations between stillbirth and areas identified more socioeconomically deprived.

Conclusion

This review suggests that area-level deprivation seems an influencing factor on stillbirth in upper-middle to high-income countries. Focused initiatives to reduce stillbirth among those at higher deprivation related risk may be useful in improving maternal and perinatal outcomes.

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在中高收入和高收入国家，地区水平的贫困作为死产的危险因素：范围审查。

背景：社会经济剥夺与健康不平等和不良围产期结局有关。贫困被描述为一个多层面的概念，国际上制定了综合指标（例如基于地区的指标）来研究人口健康。目的：本综述旨在研究中高收入国家地区贫困与死产之间关系的已发表文献。方法：采用乔安娜布里格斯研究所的方法进行范围审查。研究问题基于人口（检查死产的研究）概念（地区水平的剥夺及其对死产的影响）背景（中高收入国家）框架。检索了六个科学数据库。对结果进行筛选，检索参考文献列表以确定相关文献。完成了对研究特征和相关证据的数据提取，并对主要发现进行了叙述性总结。结果：共纳入了29项研究，来自9个国家（大多数基于英国：n = 20），发表于1998年至2023年。使用了多种综合剥夺指数，英国的多重剥夺指数（IMD）是最常见的（n = 8），其次是汤森指数和贾曼指数（n = 6和n = 3）。收入、就业、教育和获得服务是指数中最常见的贫困衡量因素。29项研究中有22项（75.9%）显示死产与社会经济贫困地区呈正相关。结论：本综述提示，在中高收入国家，地区贫困似乎是死产的一个影响因素。在贫困风险较高的人群中减少死产的重点举措可能有助于改善孕产妇和围产期结局。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Midwifery 医学-护理

CiteScore

4.50

自引率

7.40%

发文量

221

审稿时长

13.4 weeks

期刊介绍： Midwifery publishes the latest peer reviewed international research to inform the safety, quality, outcomes and experiences of pregnancy, birth and maternity care for childbearing women, their babies and families. The journal’s publications support midwives and maternity care providers to explore and develop their knowledge, skills and attitudes informed by best available evidence. Midwifery provides an international, interdisciplinary forum for the publication, dissemination and discussion of advances in evidence, controversies and current research, and promotes continuing education through publication of systematic and other scholarly reviews and updates. Midwifery articles cover the cultural, clinical, psycho-social, sociological, epidemiological, education, managerial, workforce, organizational and technological areas of practice in preconception, maternal and infant care. The journal welcomes the highest quality scholarly research that employs rigorous methodology. Midwifery is a leading international journal in midwifery and maternal health with a current impact factor of 1.861 (© Thomson Reuters Journal Citation Reports 2016) and employs a double-blind peer review process.