{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:04:12Z","timestamp":1761102252215,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,6,7]],"date-time":"2017-06-07T00:00:00Z","timestamp":1496793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multiple studies indicate a significant association between area\u2010level socio\u2010economic status (<jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content>) and adverse maternal health outcomes; however, the impact of area\u2010level <jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content> on maternal co\u2010morbidities and obstetric interventions has not been examined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the variation in maternal co\u2010morbidities and obstetric interventions across area\u2010level <jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used data from the Discharge Abstract Database that comprised birth data in Alberta between 2005\u20132007 (<jats:italic>n<\/jats:italic> = 120 285). Co\u2010morbidities and obstetric interventions were identified using validated case\u2010definitions. Material deprivation index was obtained for each dissemination area through linkage of hospitalisation and census data. Multilevel logistic regression was used to analyse the data adjusting for potential confounding variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of any co\u2010morbidity varied across area\u2010level <jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content>. Drug abuse odds ratio (OR) 2.5 (95% confidence interval (CI) 1.8, 3.5), pre\u2010existing diabetes <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.7 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.1, 2.6), and prolonged hospital stay <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.5 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.4, 1.6) were significantly more likely to occur in the most deprived areas compared to the least deprived areas. In contrast, caesarean delivery <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.9 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.8, 0.9) was less likely to occur in the most deprived areas compared to the least deprived areas. Area\u2010level deprivation explained area\u2010level variance of drug abuse, <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>, and other mental diseases only.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Many co\u2010morbidities and obstetric interventions vary at the area\u2010level, but only some are associated with area\u2010level <jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content>, and few of them vary due to the area\u2010level <jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content>. This indicates that other area\u2010level factors, in addition to area\u2010level <jats:styled-content style=\"fixed-case\">SES<\/jats:styled-content>, need to be considered when investigating maternal health and use of health interventions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12370","type":"journal-article","created":{"date-parts":[[2017,6,7]],"date-time":"2017-06-07T16:37:01Z","timestamp":1496853421000},"page":"274-283","source":"Crossref","is-referenced-by-count":6,"title":["Variation in Maternal Co\u2010morbidities and Obstetric Interventions across Area\u2010Level Socio\u2010economic Status: A Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"31","author":[{"given":"Kamala","family":"Adhikari Dahal","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahirose","family":"Premji","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary AB Canada"},{"name":"Faculty of Nursing University of Calgary Calgary AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alka B.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary AB Canada"},{"name":"Applied Research and Evaluation Services \u2010 Primary Health Care Alberta Health Services Calgary AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Williamson","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingkai","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4449-9256","authenticated-orcid":false,"given":"Amy","family":"Metcalfe","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences University of Calgary Calgary AB Canada"},{"name":"Department of Obstetrics and Gynecology University of Calgary Calgary AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/acprof:oso\/9780195138382.001.0001"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.00045"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475-9276-12-79"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-014-0094-2"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2011.01192.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1425.016"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-014-1623-8"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.045156"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301583"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)34655-2"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-11-67"},{"key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.12891\/ceog2065.2016","article-title":"Comparing maternal and perinatal outcomes in pregnancies complicated by preeclampsia superimposed chronic hypertension and preeclampsia alone","volume":"43","author":"Hu WS","year":"2016","journal-title":"Clinical and Experimental Obstetrics and Gynecology"},{"key":"e_1_2_5_14_1","unstructured":"Statistics Canada. 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