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<p>The impact of maternal education and occupation on adverse maternal–perinatal outcomes is rarely known in China. A tertiary hospital-based retrospective cohort study was conducted in Hubei, China, between 2011 and 2019 to examine the associations of maternal education level, occupational status, and their interaction effect with adverse maternal–perinatal outcomes. Data were obtained from the obstetric registry and electronic medical database and included 24,540 pregnant women, comprising singleton (n = 23,085) and twin (n = 1455) gestations. These outcomes included hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), abnormal placentation, cesarean section, preterm birth, perinatal mortality, low birth weight (LBW), intrauterine growth restriction (IUGR), low ponderal index (LPI), low Apgar score, fetal distress, macrosomia, and congenital defects. Among singleton women, lower-level education and unemployment are associated with an increased risk of HDP, preterm birth, LBW, and low Apgar score. Women with higher-level education and professional services observed a lower risk of adverse maternal–perinatal outcomes. Additive interaction between lower-level education and unemployment demonstrated a synergistic effect on maternal–perinatal outcomes, particularly for LBW, preterm birth, low Apgar score, perinatal mortality, and HDP (RERI &gt; 0; SI &gt; 1). Among women with twin gestations, a positive interaction between lower-level education and unemployment was observed for outcomes such as HDP, oligohydramnios, and fetal distress. In conclusion, maternal education and occupation affect pregnancy outcomes differently, with a stronger and more consistent negative effect in singleton pregnancies than in twin pregnancies.</p>

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Impact of maternal education levels and occupation status and their interaction effect on adverse maternal–perinatal outcomes among women with singleton and twin gestations in Hubei, China

  • 期刊论文

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  • 发表日期：

    2026年8月5日

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  • Nawsherwan,
  • Lanhua Liu,
  • Xiaoli Tang,
  • Yanmei Sun,
  • Shafaq Naeem,
  • Hong Zhang,
  • Qiang Yang,
  • Li Li,
  • Xiaoli Ding

摘要

The impact of maternal education and occupation on adverse maternal–perinatal outcomes is rarely known in China. A tertiary hospital-based retrospective cohort study was conducted in Hubei, China, between 2011 and 2019 to examine the associations of maternal education level, occupational status, and their interaction effect with adverse maternal–perinatal outcomes. Data were obtained from the obstetric registry and electronic medical database and included 24,540 pregnant women, comprising singleton (n = 23,085) and twin (n = 1455) gestations. These outcomes included hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), abnormal placentation, cesarean section, preterm birth, perinatal mortality, low birth weight (LBW), intrauterine growth restriction (IUGR), low ponderal index (LPI), low Apgar score, fetal distress, macrosomia, and congenital defects. Among singleton women, lower-level education and unemployment are associated with an increased risk of HDP, preterm birth, LBW, and low Apgar score. Women with higher-level education and professional services observed a lower risk of adverse maternal–perinatal outcomes. Additive interaction between lower-level education and unemployment demonstrated a synergistic effect on maternal–perinatal outcomes, particularly for LBW, preterm birth, low Apgar score, perinatal mortality, and HDP (RERI > 0; SI > 1). Among women with twin gestations, a positive interaction between lower-level education and unemployment was observed for outcomes such as HDP, oligohydramnios, and fetal distress. In conclusion, maternal education and occupation affect pregnancy outcomes differently, with a stronger and more consistent negative effect in singleton pregnancies than in twin pregnancies.