Author/Authors :
Dolatian, Mahrokh Social Determinant of Health Research Center - University of Social Welfare and Rehabilitation Sciences, Tehran, Iran , Mirabzadeh, Arash Social Determinant of Health Research Center - University of Social Welfare and Rehabilitation Sciences, Tehran, Iran , Setareh Forouzan, Ameneh Social Determinant of Health Research Center - University of Social Welfare and Rehabilitation Sciences, Tehran, Iran , Sajjadi, Homeira Social Determinant of Health Research Center - University of Social Welfare and Rehabilitation Sciences, Tehran, Iran , Alavimajd, Hamid Department of Biostatistics - School of Paramedical Sciences - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Mahmoodi, Zohreh Department of Midwifery - Faculty of Nursing and Midwifery - Alborz University of Medical Sciences, Karaj, Iran , Moafi, Farnoosh Department of Midwifery - Faculty of Nursing and Midwifery - Qazvin University of Medical Sciences, Qazvin, Iran
Abstract :
Background: Preterm birth is a major health problem that leads to infant morbidity
and mortality. The main goal of this study was to find the relationship between social
determinants of health and preterm delivery.
Methods: A prospective longitudinal cohort study was carried out on 500 pregnant
women in their 24th to 28th gestational weeks in 2012. The pregnant women filled
out a self-report questionnaire on the structural determinant, perceived stress, and
perceived social support. The participants were followed up until labor and the data
about mother and the newborn were collected after labor. The data were analyzed by
SPSS 21 and Lisrel 8.8 software programs using pathway analysis.
Results: The final path model fit well (CFI=0.96; RMSEA=0.060). Path analysis
showed that among structural factors, income had a direct effect (β=0.06) and the
factors of income (β=0.00594), number of children (family size) (β=-0.024), as well
as mother’s education (β=-0.0084) had the greatest overall effect on gestational age
at birth respectively. Also, the results showed that among intermediate factors of social
determinants of health, stress in the direct path (β=-0.12) and among the overall
effects, the perceived stress (β=-0.12) and perceived social support (β=0.0396) affected
the gestational age at birth.
Conclusion: The current study showed that some structural and intermediary determinants
such as income and perceived stress had an effect on preterm labor.
Keywords :
Intermediary determinants of health , Perceived social support , Perceived stress , Structural determinants of health
