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Data about ABO and related maternal risk factors were obtained from the Alberta Perinatal Health Program between 2006 and 2012. An area-level SES index derived from census data (2006) was linked to the postal code at delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Women (n=3\u200930\u2009957) having singleton live births with gestational age \u226522 weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>\n                      We estimated concentration indexes to assess inequalities across SES gradients in both rural and urban areas (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      and CIdx\n                      <jats:sub>U<\/jats:sub>\n                      , respectively) for spontaneous preterm birth (PTB), small for gestational age (SGA), large for gestational age (LGA), gestational hypertension, gestational diabetes, smoking and substance use during pregnancy and pre-pregnancy weight &gt;91\u2009kg.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The highest health inequalities disfavouring low SES groups were identified for substance abuse and smoking in rural areas (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      \u22120.38 and \u22120.23, respectively). Medium inequalities were identified for LGA (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      \u22120.08), pre-pregnancy weight &gt;91\u2009kg (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      \u22120.07), substance use (CIdx\n                      <jats:sub>U<\/jats:sub>\n                      \u22120.15), smoking (CIdx\n                      <jats:sub>U<\/jats:sub>\n                      \u22120.14), gestational diabetes (CIdx\n                      <jats:sub>U<\/jats:sub>\n                      \u22120.10) and SGA (CIdx\n                      <jats:sub>U<\/jats:sub>\n                      \u22120.07). Low inequalities were identified for PTB (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      \u22120.05; CIdx\n                      <jats:sub>U<\/jats:sub>\n                      \u22120.05) and gestational diabetes (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      \u22120.04). Inequalities disfavouring high SES groups were identified for gestational hypertension (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      +0.04), SGA (CIdx\n                      <jats:sub>R<\/jats:sub>\n                      +0.03) and LGA (CIdx\n                      <jats:sub>U<\/jats:sub>\n                      +0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ABO and related maternal risk factors were unequally distributed across the socioeconomic gradient in urban\u2013rural settings, with the greatest concentrations in lower SES groups of rural areas. Future research is needed on underlying mechanisms driving SES gradients in perinatal health across the rural\u2013urban spectrum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-033296","type":"journal-article","created":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T04:45:16Z","timestamp":1580705116000},"page":"e033296","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Socioeconomic gradients of adverse birth outcomes and related maternal factors in rural and urban Alberta, Canada: a concentration index approach"],"prefix":"10.1136","volume":"10","author":[{"given":"Maria","family":"Ospina","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro Rom\u00e1n","family":"Osornio-Vargas","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene C","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Crawford","sequence":"additional","affiliation":[{"name":"Alberta Perinatal Health Program, Alberta Health Services, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8054-9113","authenticated-orcid":false,"given":"Khalid","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1627-3647","authenticated-orcid":false,"given":"Jesus","family":"Serrano-Lomelin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,2]]},"reference":[{"key":"2025121409200197000_10.1.e033296.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.08.062554"},{"key":"2025121409200197000_10.1.e033296.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000365790","article-title":"Global prevalence of small for gestational age births","volume":"81","author":"Black","year":"2015","journal-title":"Nestle Nutr Inst Workshop Ser"},{"key":"2025121409200197000_10.1.e033296.3","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000177"},{"key":"2025121409200197000_10.1.e033296.4","doi-asserted-by":"crossref","DOI":"10.1186\/1742-4755-10-S1-S2","article-title":"Born too soon: the global epidemiology of 15 million preterm births","volume":"10","author":"Blencowe","year":"2013","journal-title":"Reprod Health"},{"key":"2025121409200197000_10.1.e033296.5","unstructured":"Solar O , Irwin A . 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