Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohort
Abstract Background Pregnancy is a period marked by significant physiological and psychological changes in women and increased fetal nutritional requirements, necessitating maternal adaptation and behavior modifications. Clinicians and health institutions recommend pregnant women engage in healthy p...
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BMC
2025-05-01
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| Series: | Population Health Metrics |
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| Online Access: | https://doi.org/10.1186/s12963-025-00382-0 |
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| author | Francesca Bitonti Angelo Mazza Martina Barchitta Andrea Maugeri Roberta Magnano San Lio Giuliana Favara Claudia La Mastra Maria Clara La Rosa Fabiola Galvani Elisa Pappalardo Carla Ettore Giuseppe Ettore Federico Mertoli Carmela Elita Schillaci Antonella Agodi |
| author_facet | Francesca Bitonti Angelo Mazza Martina Barchitta Andrea Maugeri Roberta Magnano San Lio Giuliana Favara Claudia La Mastra Maria Clara La Rosa Fabiola Galvani Elisa Pappalardo Carla Ettore Giuseppe Ettore Federico Mertoli Carmela Elita Schillaci Antonella Agodi |
| author_sort | Francesca Bitonti |
| collection | DOAJ |
| description | Abstract Background Pregnancy is a period marked by significant physiological and psychological changes in women and increased fetal nutritional requirements, necessitating maternal adaptation and behavior modifications. Clinicians and health institutions recommend pregnant women engage in healthy practices, such as smoking and alcohol cessation, folic acid consumption, vaccinations, and the like. As behavioral changes in general, the individual's conduct during pregnancy is also influenced not only by personal socio-economic status but also by the socio-economic conditions of the individual's area of residence. This mechanism is recognized by the social epidemiological approach and relates to the concept of neighborhood effect on individual health-related choices. Leveraging such considerations, the work aims to explore the association between selected behaviors recommended by clinicians during pregnancy and specific contextual variables in the residential areas where pregnant women live. Methods Data from the "MAMI-MED" cohort, recruiting pregnant women during the first prenatal visit at a hospital in Catania (Italy), were analyzed. The cohort provides a valuable resource for investigating the relationship between various exposures during pregnancy and the health outcomes of both mothers and infants. Geocoding techniques were employed to link individual-level data to selected contextual variables related to education, income, unemployment, and housing costs in the participants' residential areas. Mann–Whitney test, Kruskal–Wallis tests, logistic regressions and mixtures of regressions models with concomitant variables are implemented 1) to investigate the associations between contextual covariates and individual responses, 2) to assess the presence of latent sub-groups of the population reacting differently to the same contextual factors. Results The results of Mann–Whitney and Kruskal–Wallis tests, and logistic regressions indicated that neighborhood's socio-economic characteristics, such as educational level and unemployment rate, are associated with women's behaviors during pregnancy, smoking cessation in particular. Results from the logistic regression for BMI showed that obese and overweight individuals tend to live in neighborhoods where the percentage of individuals holding at least a bachelor's degree is comparatively lower. A mixture of regressions predicting individual BMI detected the presence of two latent groups in the population under analysis. The main finding seems to suggest that people living in worse socio-economic environments have a higher sensitivity to changes in education conditions, with respect to individuals living in better-off neighborhoods. Conclusions These findings highlight the importance of considering social and contextual dimensions in understanding and promoting healthy behaviors during pregnancy. |
| format | Article |
| id | doaj-art-a3c71b9c7e6a47f2bb65da99be1a7ac5 |
| institution | DOAJ |
| issn | 1478-7954 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | Population Health Metrics |
| spelling | doaj-art-a3c71b9c7e6a47f2bb65da99be1a7ac52025-08-20T03:16:51ZengBMCPopulation Health Metrics1478-79542025-05-0123111010.1186/s12963-025-00382-0Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohortFrancesca Bitonti0Angelo Mazza1Martina Barchitta2Andrea Maugeri3Roberta Magnano San Lio4Giuliana Favara5Claudia La Mastra6Maria Clara La Rosa7Fabiola Galvani8Elisa Pappalardo9Carla Ettore10Giuseppe Ettore11Federico Mertoli12Carmela Elita Schillaci13Antonella Agodi14Department of Economics and Business, University of CataniaDepartment of Economics and Business, University of CataniaDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of CataniaDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of CataniaDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of CataniaDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of CataniaDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of CataniaDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of CataniaDepartment of Obstetrics and Gynaecology, Azienda Di Rilievo Nazionale E Di Alta Specializzazione (ARNAS) Garibaldi NesimaDepartment of Obstetrics and Gynaecology, Azienda Di Rilievo Nazionale E Di Alta Specializzazione (ARNAS) Garibaldi NesimaDepartment of Obstetrics and Gynaecology, Azienda Di Rilievo Nazionale E Di Alta Specializzazione (ARNAS) Garibaldi NesimaDepartment of Obstetrics and Gynaecology, Azienda Di Rilievo Nazionale E Di Alta Specializzazione (ARNAS) Garibaldi NesimaDepartment of Economics and Business, University of CataniaDepartment of Economics and Business, University of CataniaDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of CataniaAbstract Background Pregnancy is a period marked by significant physiological and psychological changes in women and increased fetal nutritional requirements, necessitating maternal adaptation and behavior modifications. Clinicians and health institutions recommend pregnant women engage in healthy practices, such as smoking and alcohol cessation, folic acid consumption, vaccinations, and the like. As behavioral changes in general, the individual's conduct during pregnancy is also influenced not only by personal socio-economic status but also by the socio-economic conditions of the individual's area of residence. This mechanism is recognized by the social epidemiological approach and relates to the concept of neighborhood effect on individual health-related choices. Leveraging such considerations, the work aims to explore the association between selected behaviors recommended by clinicians during pregnancy and specific contextual variables in the residential areas where pregnant women live. Methods Data from the "MAMI-MED" cohort, recruiting pregnant women during the first prenatal visit at a hospital in Catania (Italy), were analyzed. The cohort provides a valuable resource for investigating the relationship between various exposures during pregnancy and the health outcomes of both mothers and infants. Geocoding techniques were employed to link individual-level data to selected contextual variables related to education, income, unemployment, and housing costs in the participants' residential areas. Mann–Whitney test, Kruskal–Wallis tests, logistic regressions and mixtures of regressions models with concomitant variables are implemented 1) to investigate the associations between contextual covariates and individual responses, 2) to assess the presence of latent sub-groups of the population reacting differently to the same contextual factors. Results The results of Mann–Whitney and Kruskal–Wallis tests, and logistic regressions indicated that neighborhood's socio-economic characteristics, such as educational level and unemployment rate, are associated with women's behaviors during pregnancy, smoking cessation in particular. Results from the logistic regression for BMI showed that obese and overweight individuals tend to live in neighborhoods where the percentage of individuals holding at least a bachelor's degree is comparatively lower. A mixture of regressions predicting individual BMI detected the presence of two latent groups in the population under analysis. The main finding seems to suggest that people living in worse socio-economic environments have a higher sensitivity to changes in education conditions, with respect to individuals living in better-off neighborhoods. Conclusions These findings highlight the importance of considering social and contextual dimensions in understanding and promoting healthy behaviors during pregnancy.https://doi.org/10.1186/s12963-025-00382-0Birth cohortPregnancyPublic healthMAMI-MEDNeighborhood effect |
| spellingShingle | Francesca Bitonti Angelo Mazza Martina Barchitta Andrea Maugeri Roberta Magnano San Lio Giuliana Favara Claudia La Mastra Maria Clara La Rosa Fabiola Galvani Elisa Pappalardo Carla Ettore Giuseppe Ettore Federico Mertoli Carmela Elita Schillaci Antonella Agodi Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohort Population Health Metrics Birth cohort Pregnancy Public health MAMI-MED Neighborhood effect |
| title | Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohort |
| title_full | Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohort |
| title_fullStr | Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohort |
| title_full_unstemmed | Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohort |
| title_short | Socio-economic contextual determinants and behavioral changes during pregnancy: evidence from the "MAMI-MED" cohort |
| title_sort | socio economic contextual determinants and behavioral changes during pregnancy evidence from the mami med cohort |
| topic | Birth cohort Pregnancy Public health MAMI-MED Neighborhood effect |
| url | https://doi.org/10.1186/s12963-025-00382-0 |
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