The Relationship Between Maternal Education and Child Health Outcomes in Urban Australian Children in the First 12 Months of Life
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To describe the relationship between maternal education and child health outcomes at 12 months of age in a cohort of children in urban Australia, and to determine whether this relationship could be explained by the intermediate factors of maternal health behaviour and the social environmental context.
Data were derived from The Environments for Health Living Griffith Birth Cohort Study. Women attending their third trimester antenatal appointment at one of three public hospitals were recruited between 2006 and 2010 and invited to complete a 48-item, baseline self-administered questionnaire. Twelve months following the birth of their baby, a follow-up questionnaire consisting of 63 items was distributed.
Women for whom complete follow-up data were not available were different from women who did complete follow-up data. The children of women with follow-up data—whom at the time of their pregnancy had not completed school or whose highest level of education was secondary school or a trade—had respectively a 59 and 57 % increased chance of having had a respiratory/infectious disease or injury in the first year of life (according to parent proxy-reports), compared to children of women with a tertiary education. When maternal behavioural and social environmental factors during pregnancy were included in the model (n=1914), the effect of secondary education was still evident but with a reduced odds ratio of 1.35 (95 % CI 1.07–1.72) and 1.19 (95 % CI 0.87–1.64), respectively. The effect of not having completed school was no longer significant.
Results indicate that the relationship between maternal education and child outcomes may be mediated by maternal social environmental and behavioural factors. Results are likely an underestimation of the effect size, given the under representation in our cohort of participants with maternal characteristics associated with elevated risk of infant morbidity.
KeywordsChild Maternal educational status Health behavior Social environment
The research reported in this publication is part of the Griffith Study of Population Health: Environments for Healthy Living (EFHL) (Australian and New Zealand Clinical Trials Registry: ACTRN12610000931077). Core funding to support EFHL is provided by Griffith University. The EFHL project was conceived by Professor Rod McClure, Dr Cate Cameron, Professor Judy Searle, and Professor Ronan Lyons. The authors are thankful for the contributions of the Project Manager, Rani Scott, and the current and past Database Managers. The authors gratefully acknowledge the administrative staff, research staff, and the hospital antenatal and birth suite midwives of the participating hospitals for their valuable contributions to the study, in addition to the expert advice provided by Research Investigators throughout the project. Dr Cameron was supported by a Public Health Fellowship (ID 428254) from the National Health and Medical Research Council (NHMRC) Australia.
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