EFFECTS ON BIRTH-WEIGHT OF SMOKING, ALCOHOL, CAFFEINE, SOCIOECONOMIC-FACTORS, AND PSYCHOSOCIAL STRESS
EFFECTS ON BIRTH-WEIGHT OF SMOKING, ALCOHOL, CAFFEINE, SOCIOECONOMIC-FACTORS, AND PSYCHOSOCIAL STRESS
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DOI：
10.1136/bmj.298.6676.795
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发表时间：
1989-03-25
影响因子：
105.7
通讯作者：
STEWART, CM
中科院分区：
文献类型：
--
作者：
BROOKE, OG;ANDERSON, HR;STEWART, CM
研究吸烟、饮酒、咖啡因摄入、社会经济因素和心理社会压力对出生体重的影响。设计.sbd.前瞻性人群研究。地点：内伦敦区综合医院。连续接触了1860名预约分娩的白色妇女。136人被拒绝，211人因其他原因（搬家、流产、随后拒绝）未能完成研究，留下1513人的样本。那些不会说英语，在24周后预订，患有胰岛素依赖型糖尿病或多胎妊娠的女性被排除在外。数据由研究访谈者在预约时（一般健康问卷、改良的Paykel's访谈和Eysenck个性问卷）和妊娠17、28和36周时以及从结构化的产前和产科记录中获得。评估的变量包括吸烟，饮酒，咖啡因消费，以及40多个社会经济状态和心理社会压力指标，包括社会阶层，住宿，教育，就业，收入，焦虑和抑郁，压力生活事件，社会压力，社会支持，个性和对怀孕的态度。出生体重根据妊娠期进行校正，并根据母亲身高、产次和婴儿性别进行调整。吸烟是最重要的单因素（校正出生体重减少5%）。被动吸烟不显著（减少0.5%）。在控制吸烟后，酒精只对吸烟者有影响，咖啡因的影响变得不显着。只有四个社会经济和压力因素显着降低出生体重，这些影响变得不显着后，吸烟被控制。结论：社会和心理因素对校正胎龄后的出生体重（胎儿生长）几乎没有直接影响，吸烟是导致这一人群出生体重变化的主要环境因素。
Objective.sbd.To investigate the effects of smoking, alcohol, and caffeine consumption and socioeconomic factors and psychosocial stress on birth weight. Design.sbd.Prospective population study. Setting.sbd.District general hospital in inner London. Participants.sbd.A consecutive series of 1860 white women booking for delivery were approached. 136 Refused and 211 failed to complete the study for other reasons (moved, abortion, subsequent refusal), leaving a sample of 1513. Women who spoke no English, booked after 24 weeks, had insulin dependent diabetes, or had a multiple pregnancy were excluded. Measurements.sbd.Data were obtained by research interviewers at booking (general health questionnaire, modified Paykel''s interview, and Eysenck personality questionnaire) and at 17, 28, and 36 weeks'' gestation and from the structured antenatal and obstetric record. Variables assessed included smoking, alcohol consumption, caffeine consumption, and over 40 indicators of socioeconomic state and psychosocial stress, including social class, tenure of accommodation, education, employment, income, anxiety and depression, stressful life events, social stress, social support, personality, and attitudes to pregnancy. Birth weight was corrected for gestation and adjusted for maternal height, parity, and baby''s sex. Main results.sbd.Smoking was the most important single factor (5% reduction in corrected birth weight). Passive smoking was not significant (0.5% reduction). After smoking was controlled for, alchol had an effect only in smokers and the effects of caffeine became non-significant. Only four of the socioeconomic and stress factors significantly reduced birth weight and these effects became non-significant after smoking was controlled for. Conclusions.sbd.Social and psychological factors have little or no direct effect on birth weight corrected for gestational age (fetal growth), and the main environmental cause of its variation in this population was smoking.