Mothers' childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways
Mothers' childhood hardship forecasts adverse pregnancy outcomes: Role of inflammatory, lifestyle, and psychosocial pathways
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DOI：
10.1016/j.bbi.2017.04.018
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发表时间：
2017-10-01
影响因子：
15.1
通讯作者：
Borders, Ann
中科院分区：
文献类型：
--
作者：
Miller, Gregory E.;Culhane, Jennifer;Borders, Ann
研究表明，经济困难对健康的影响可以代代相传。其中一些差异被认为会在妊娠期间遗传给后代。但这一假设尚未在当代美国样本中得到检验，传播机制也尚未被表征。因此，这项研究有两个目标：首先，确定童年时期经历经济困难的妇女是否表现出较高的不良分娩结果发生率；其次，评估炎症、社会心理、生活方式和产科特征对这一现象的影响。这项前瞻性研究招募了 744 名单胎妊娠女性（59.1% 白人；16.3% 黑人；18.7% 拉丁裔；5.9% 其他）。童年的经济困难是通过自我报告来衡量的。出生结果包括妊娠时长和早产发生率；出生体重百分位和小于胎龄；住院时间和入住特殊护理托儿所的时间。分析显示，即使在对人口统计、孕产妇教育和产科混杂因素进行调整后，母亲的童年经济困难与多种不良出生结果独立相关。在经济条件较差的条件下长大的妇女妊娠期较短，早产率较高。他们的婴儿出生体重较低，胎龄较小的可能性更大，住院时间更长，进入特殊护理托儿所的人数也更多。中介分析表明这些关联是通过多种途径产生的，并强调了炎症、教育、肥胖和产科并发症的作用。总的来说，这些发现表明，儿童时期的经济困难使妇女容易出现不良的出生结果，并强调了可能的行为和生物学机制。 (C) 2017 Elsevier Inc. 保留所有权利。
Research suggests the health consequences of economic hardship can be transmitted across generations. Some of these disparities are thought to be passed to offspring during gestation. But this hypothesis has not been tested in contemporary American samples, and the mechanisms of transmission have not been characterized. Accordingly, this study had two goals: first, to determine if women exposed to economic hardship during childhood showed higher rates of adverse birth outcomes; and second, to evaluate the contribution of inflammation, psychosocial, lifestyle, and obstetric characteristics to this phenomenon. This prospective study enrolled 744 women with singleton pregnancies (59.1% White; 16.3% Black; 18.7% Latina; 5.9% Other). Childhood economic hardship was measured by self-report. Birth outcomes included length of gestation and incidence of preterm birth; birth weight percentile and small for gestational age; length of hospital stay and admission to Special Care Nursery. Analyses revealed that mothers' childhood economic hardship was independently associated with multiple adverse birth outcomes, even following adjustment for demographics, maternal education, and obstetrical confounders. Women raised in economically disadvantaged conditions had shorter gestation length and higher preterm delivery rates. Their babies had lower birth weights, were more likely to be small for gestational age, stayed in the hospital longer, and had more Special Care Nursery admissions. Mediation analyses suggested these associations arose through multiple pathways, and highlighted roles for inflammation, education, adiposity, and obstetric complications. Collectively, these findings suggest that childhood economic hardship predisposes women to adverse birth outcomes, and highlights likely behavioral and biological mechanisms. (C) 2017 Elsevier Inc. All rights reserved.