Determinants of health and pregnancy and birth outcomes: an overview

Abstract Introduction This study examines the influence of health determinants on pregnancy and birth outcomes. The aim is to provide a clear and updated view of the overall framework characterizing the birth experience, with crucial implications for clinical practice, research, and health policy. Methods Data analysis pertains to the Certificate of Assistance for Birth (CAP) concerning residents in the territory of AUSL South-East Tuscany in the years 2021 and 2022. The number of women of childbearing age in Tuscany in 2022 is 150,959, while the number of births analyzed in the study is 9,053. The study conducts multivariate analysis between factors and pregnancy-related outcomes. Results Controlling for age, citizenship and others factors, the risk of cesarean section is significantly higher (p < 0.05) among mothers: over 40 years old (OR = 2.09), with education levels of lower secondary (OR = 1.21) and upper secondary (OR = 1.23) compared to a degree, not employed (OR = 1.25) and homemakers (OR = 1.45) compared to employed, overweight/obese (OR = 1.41), with gestational diabetes (OR = 1.16), smoking during pregnancy (OR = 1.27), with gestational hypertension (OR = 2.81). Controlling for age, citizenship and others factors, the risk of term low birth weight is significantly higher (p < 0.05) among mothers: over 40 years old (OR = 1.76), not employed (OR = 1.76) and homemakers (OR = 1.34) compared to employed, smoking more than 3 cigarettes daily during pregnancy (OR = 1.31) not significant, with gestational hypertension (OR = 5.57), nulliparous (OR = 1.42). Controlling for age, citizenship and other factors, the risk of premature birth is significantly higher (p < 0.05) among mothers: with gestational hypertension (OR = 5.22), nulliparous (OR = 1.89), smoking during pregnancy (OR = 1.59). Conclusions The results underscore the importance of carefully monitoring and managing these risk factors during pregnancy to improve outcomes for both mother and baby. Key messages • Understanding the determinants that influence birth outcomes plays a fundamental role. • The importance of Early Childhood Development and early interventions can improve children’s health and well-being.