Changes in individual and contextual socio-economic level influence on reproductive behavior in Spanish women in the MCC-Spain study
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Contextual socioeconomicEducational levelOccupationUrban vulnerability indexPregnanciesAbortionsBreastfeedingHormonal therapy
Gómez-Acebo, I., Dierssen-Sotos, T., Palazuelos, C. et al. Changes in individual and contextual socio-economic level influence on reproductive behavior in Spanish women in the MCC-Spain study. BMC Women's Health 20, 72 (2020). [https://doi.org/10.1186/s12905-020-00936-4]
SponsorshipInstituto de Salud Carlos III; European Union (EU) PI08/1770 PI08/0533 PI08/1359 PI09/00773 PI09/01286 PI09/01903 PI09/02078 PI09/01662 PI11/01403 PI11/01889 PI11/00226 PI11/01810 PI11/02213 PI12/00488 PI12/00265 PI12/01270 PI12/00715 PI12/00150 PI14/01219 PI14/00613 PI15/00069; Instituto de Salud Carlos III API 10/09; Junta de Castilla y Leon LE22A10-2; Junta de Andalucía 2009S0143; Conselleria de Sanitat of the Generalitat Valenciana AP 061/10; La Caixa Foundation 2010ACUP 00310; Regional Government of the Basque Country; Consejeria de Sanidad de la Region de Murcia; European Commission Joint Research Centre FOOD-CT-2006-036224-HIWATE; Spanish Association Against Cancer (AECC) Scientific Foundation; Catalan Government DURSI 2014SGR647; Fundacion Caja de Ahorros de Asturias; University of Oviedo; Societat Catalana de Digestologia; European Cooperation in Science and Technology (COST) BM1206
Background The association between socioeconomic level and reproductive factors has been widely studied. For example, it is well known that women with lower socioeconomic status (SES) tend to have more children, the age at first-born being earlier. However, less is known about to what extent the great socioeconomic changes occurred in a country (Spain) could modify women reproductive factors. The main purpose of this article is to analyze the influence of individual and contextual socioeconomic levels on reproductive factors in Spanish women, and to explore whether this influence has changed over the last decades. Methods We performed a cross-sectional design using data from 2038 women recruited as population-based controls in an MCC-Spain case-control study. Results Higher parent’s economic level, education level, occupational level and lower urban vulnerability were associated with higher age at first delivery and lower number of pregnancies. These associations were stronger for women born after 1950: women with unfinished primary education had their first delivery 6 years before women with high education if they were born after 1950 (23.4 vs. 29.8 years) but only 3 years before if they were born before 1950 (25.7 vs. 28.0 years). For women born after 1950, the number of pregnancies dropped from 2.1 (unfinished primary school) to 1.7 (high education), whereas it remained almost unchanged in women born before 1950. Conclusions Reproductive behavior was associated with both individual and area-level socio-economic indicators. Such association was stronger for women born after 1950 regarding age at first delivery and number of pregnancies and for women born before 1950 regarding consumption of hormonal contraceptives or postmenopausal therapy.