Co-causation of reduced newborn size by maternal undernutrition, infections, and inflammation
Co-causation of reduced newborn size by maternal undernutrition, infections, and inflammation
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DOI：
10.1111/mcn.12585
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发表时间：
2018-07-01
影响因子：
3.4
通讯作者：
Dewey, Kathryn G.
中科院分区：
文献类型：
--
作者：
Ashorn, Per;Hallamaa, Lotta;Dewey, Kathryn G.
每年有超过2000万婴儿出生时体重过轻。小新生儿死亡率、生长衰竭和其他不良后果的风险增加。已经确定了许多新生儿体重小的产前危险因素，但针对这些因素的个别干预措施并没有显著改善所关注的健康结果。我们测试了一个假设，即在低收入环境中，新生儿的大小受到多个母亲暴露的共同影响，并表征了这些暴露与新生儿大小相关的途径。这是一项前瞻性队列研究，孕妇及其后代在马拉维农村的干预试验中筑巢。我们收集了有关母体和胎盘特征的信息，并使用回归分析、结构方程建模和随机森林模型来构建这些特征与新生儿年龄体重Z-score和年龄长度Z-score之间的直接和间接关联的通路图。我们使用多重输入来推断任何缺失数据的值。在1179名孕妇及其婴儿中，初产、体重指数、妊娠20周前血浆α -1-酸性糖蛋白浓度、妊娠体重增加、妊娠持续时间、胎盘重量和新生儿年龄体重z -评分可直接预测新生儿年龄体重z -评分(p
More than 20 million babies are born with low birthweight annually. Small newborns have an increased risk for mortality, growth failure, and other adverse outcomes. Numerous antenatal risk factors for small newborn size have been identified, but individual interventions addressing them have not markedly improved the health outcomes of interest. We tested a hypothesis that in low-income settings, newborn size is influenced jointly by multiple maternal exposures and characterized pathways associating these exposures with newborn size. This was a prospective cohort study of pregnant women and their offspring nested in an intervention trial in rural Malawi. We collected information on maternal and placental characteristics and used regression analyses, structural equation modelling, and random forest models to build pathway maps for direct and indirect associations between these characteristics and newborn weight-for-age Z-score and length-for-age Z-score. We used multiple imputation to infer values for any missing data. Among 1,179 pregnant women and their babies, newborn weight-for-age Z-score was directly predicted by maternal primiparity, body mass index, and plasma alpha-1-acid glycoprotein concentration before 20weeks of gestation, gestational weight gain, duration of pregnancy, placental weight, and newborn length-for-age Z-score (p