Urban social environment and low birth weight in 360 Latin American cities.
Urban social environment and low birth weight in 360 Latin American cities.
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DOI：
10.1186/s12889-021-10886-7
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发表时间：
2021-04-26
影响因子：
4.5
通讯作者：
Diez-Roux AV
中科院分区：
文献类型：
--
作者：
Rodríguez López S;Tumas N;Ortigoza A;de Lima Friche AA;Diez-Roux AV
使用SALURBAL项目(拉丁美洲的城市健康；Salud Urbana en américa Latina)汇编的数据，我们量化了拉丁美洲各城市低出生体重(LBW)的变异性，并评估了不同级别(产妇、次城市和城市)的社会经济特征与LBW患病率的关系。样本包括8个国家、360个城市、1321个城市内的行政区(次城市单位)和2014年超过450万名出生人口的出生登记。我们利用每个国家现有的最接近的全国人口普查，将出生登记中的孕产妇教育与次城市和城市的社会经济特征数据联系起来。我们对聚合数据应用了线性和泊松随机截取多水平模型。按国家划分的城市LBW患病率的中位数从危地马拉的13%高到秘鲁的5%(所有城市的中位数为7.8%)。次城市之间的LBW变异性大多在国家之间，但一个国家内和城市内部的城市之间也有相当大的比例。在完全校正模型中，母亲受教育程度低与LBW患病率(小学以下与中学完成或以上的患病率比(PRR)1.12，95%可信区间1.10，1.13)相关。相反，在调整了母亲教育和年龄、城市人口规模和城市国内生产总值后，较高的郊区教育和较好的城市社会环境指数与较高的LBW患病率独立相关(PRR 1.04，95%CI 1.03，每SD较高的郊区教育1.04，PRR 1.02，95%CI 1.00，1.04/SD较高的SEI)。城市规模越大，LBW患病率越高(PRR1.06；95%可信区间1.01，1.12)。我们的发现突出了LBW分布的异质性，以及母亲教育、当地和更广泛的社会环境在塑造拉丁美洲城市环境中LBW的重要性。建议采取背景敏感的干预措施，以改善妇女的教育，以解决该区域的LBW问题。网上版载有补充材料，可在10.1186/s12889-021-10886-7查阅。
Using data compiled by the SALURBAL project (Urban Health in Latin America; ‘Salud Urbana en América Latina’) we quantified variability in low birth weight (LBW) across cities in Latin America, and evaluated the associations of socio-economic characteristics at various levels (maternal, sub-city and city) with the prevalence of LBW. The sample included 8 countries, 360 cities, 1321 administrative areas within cities (sub-city units) and birth registers of more than 4.5 million births for the year 2014. We linked maternal education from birth registers to data on socioeconomic characteristics of sub-cities and cities using the closest available national population census in each country. We applied linear and Poisson random-intercept multilevel models for aggregated data. The median prevalence of city LBW by country ranged from a high of 13% in Guatemala to a low of 5% in Peru (median across all cities was 7.8%). Most of the LBW variability across sub-cities was between countries, but there were also significant proportions between cities within a country, and within cities. Low maternal education was associated with higher prevalence of LBW (Prevalence rate ratios (PRR) for less than primary vs. completed secondary or more 1.12 95% CI 1.10, 1.13) in the fully adjusted model. In contrast, higher sub-city education and a better city social environment index were independently associated with higher LBW prevalence after adjustment for maternal education and age, city population size and city gross domestic product (PRR 1.04 95% CI 1.03, 1.04 per SD higher sub-city education and PRR 1.02 95% CI 1.00, 1.04 per SD higher SEI). Larger city size was associated with a higher prevalence of LBW (PRR 1.06; 95% CI 1.01, 1.12). Our findings highlight the presence of heterogeneity in the distribution of LBW and the importance of maternal education, local and broader social environments in shaping LBW in urban settings of Latin America. Implementing context-sensitive interventions guided to improve women’s education is recommended to tackle LBW in the region. The online version contains supplementary material available at 10.1186/s12889-021-10886-7.
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影响因子：
3.3
作者：
de Souza Buriol VC;Hirakata V;Goldani MZ;da Silva CH
通讯作者：
da Silva CH
影响因子：
10.4
作者：
Fleischer NL;Merialdi M;van Donkelaar A;Vadillo-Ortega F;Martin RV;Betran AP;Souza JP
通讯作者：
Souza JP
影响因子：
--
作者：
Jefferis, BJMH;Power, C;Hertzman, C
通讯作者：
Hertzman, C
DOI：
10.1590/s0102-311x2011000200004
发表时间：
2011-02-01
期刊：
Cadernos de Saúde Pública
影响因子：
--
作者：
Moraes, Anaelena Bragança de;Zanini, Roselaine Ruviaro;Riboldi, João
通讯作者：
Riboldi, João
DOI：
10.1016/s2214-109x(15)00038-8
发表时间：
2015-07
期刊：
The Lancet. Global health
影响因子：
--
作者：
Fall CH;Sachdev HS;Osmond C;Restrepo-Mendez MC;Victora C;Martorell R;Stein AD;Sinha S;Tandon N;Adair L;Bas I;Norris S;Richter LM;COHORTS investigators
通讯作者：
COHORTS investigators