Data from: Social inequality and infant health in the UK: systematic review and meta-analyses

OBJECTIVES: To determine the association between area and individual measures of social disadvantage and infant health in the United Kingdom (UK). DESIGN: Systematic review and meta-analyses. DATA SOURCES: 26 databases and web sites, reference lists, experts in the field and hand-searching. STUDY SELECTION: 36 prospective and retrospective observational studies with socio-economic data and health outcomes for infants in the UK, published from 1994 to May 2011. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers assessed the methodological quality of the studies and abstracted data. Where possible, study outcomes were reported as odds ratios for the highest versus the lowest deprivation quintile. RESULTS: In relation to the highest versus lowest area deprivation quintiles the odds of adverse birth outcomes were 1.81 (1.71 to 1.92) for low birth weight, 1.67 (1.42 to 1.96) for premature birth and 1.54 (1.39 to 1.72) for still birth. For infant mortality rates the odds ratios were 1.72 (1.37 to 2.15) overall, 1.61 (1.08 to 2.39) for neonatal and 2.31 (2.03 to 2.64) for post-neonatal mortality. For lowest versus highest social class, the odds were 1.79 (1.71 to 1.92) for premature birth, 1.52 (1.44 to 1.61) for overall infant mortality, 1.42 (1.33 to1.51) for neonatal and 1.69 (1.53 to 1.87) for post-neonatal mortality. There are similar patterns for other infant health outcomes with the possible exception of failure to thrive, where there is no clear association. CONCLUSIONS: This review quantifies the influence of social disadvantage on infant outcomes in the UK. The magnitude of effect is similar across a range of area and individual deprivation measures and birth and mortality outcomes. Further research should explore the factors that are more proximal to mothers and infants, to help throw light on the most appropriate times to provide support and the form(s) that this support should take.

研究目标：明确英国（UK）区域层面与个体层面的社会剥夺（social disadvantage）指标与婴儿健康之间的关联。研究设计：系统综述（systematic review）与荟萃分析（meta-analyses）。数据来源：涵盖26个数据库与网站、参考文献列表、领域内专家及手工检索。研究筛选：纳入1994年至2011年5月发表的、包含英国婴儿社会经济数据与健康结局的36项前瞻性与回顾性观察性研究。数据提取与合成：由两名独立评审员评估研究的方法学质量并提取数据。在可行情况下，将研究结局报告为最高与最低剥夺五分位组（deprivation quintile）间的比值比（odds ratio）。结果：对比区域层面最高与最低剥夺五分位组，低出生体重（low birth weight）不良出生结局的比值比为1.81（1.71~1.92），早产（premature birth）为1.67（1.42~1.96），死产（still birth）为1.54（1.39~1.72）。婴儿死亡率的总体比值比为1.72（1.37~2.15），其中新生儿期死亡率为1.61（1.08~2.39），新生儿后期死亡率为2.31（2.03~2.64）。对比最低与最高社会阶层（social class），早产的比值比为1.79（1.71~1.92），总体婴儿死亡率为1.52（1.44~1.61），新生儿期死亡率为1.42（1.33~1.51），新生儿后期死亡率为1.69（1.53~1.87）。其他婴儿健康结局亦呈现相似模式，仅生长发育迟缓（failure to thrive）可能例外，未发现明确关联。结论：本综述量化了英国社会剥夺对婴儿结局的影响幅度。区域与个体层面的各类剥夺指标，以及各类出生与死亡结局的效应强度均较为相近。未来研究应探索与母婴更为直接相关的影响因素，以明确提供支持的最佳时机及支持形式。