Born early and born poor: An eco-bio-developmental model for poverty and preterm birth.
Born early and born poor: An eco-bio-developmental model for poverty and preterm birth.
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DOI：
10.3233/npm-15814098
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发表时间：
2015-01-01
影响因子：
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通讯作者：
Shah, S I
中科院分区：
文献类型：
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作者：
Brumberg, H L;Shah, S I
贫困与儿童的长期认知结果有关。贫困也与早产有关，而早产又与不良的认知结果有关。然而，贫困对早产的影响程度以及发生早产的拟议机制尚未得到很好的描述。此外，还没有审查贫困对早产儿入学准备的影响。随着美国儿童贫困水平的持续上升，我们研究了与贫困背景下的早产相关的生理、神经、认知和学习结果的证据。我们使用收集到的证据来提出一个生态-生物-发展模型，强调贫困是一种有毒的压力，它容易导致早产，并且通过表观遗传力量，可以持续到下一代。这些发育高风险早产儿持续的产后社会劣势与神经发育不良、入学准备不足和教育程度下降密切相关，这些因素可能使贫困循环永久化。我们建议采取社会补救措施，旨在减少贫困对母亲、父亲和儿童的影响，这可能会有效减轻早产的负担。
Poverty is associated with adverse long-term cognitive outcomes in children. Poverty is also linked with preterm delivery which, in turn, is associated with adverse cognitive outcomes. However, the extent of the effect of poverty on preterm delivery, as well as proposed mechanisms by which they occur, have not been well described. Further, the impact of poverty on preterm school readiness has not been reviewed. As the childhood poverty level continues to increase in the U.S., we examine the evidence around physiological, neurological, cognitive and learning outcomes associated with prematurity in the context of poverty. We use the evidence gathered to suggest an Eco-Bio-Developmental model, emphasizing poverty as a toxic stress which predisposes preterm birth and which, via epigenetic forces, can continue into the next generation. Continued postnatal social disadvantage for these developmentally high-risk preterm infants is strongly linked with poor neurodevelopmental outcomes, decreased school readiness, and decreased educational attainment which can perpetuate the poverty cycle. We suggest social remedies aimed at decreasing the impact of poverty on mothers, fathers, and children which may be effective in reducing the burden of preterm birth.