Parental health status and infant outcomes: Upstate KIDS Study.
Parental health status and infant outcomes: Upstate KIDS Study.
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DOI：
10.1016/j.fertnstert.2017.10.009
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发表时间：
2018-03
影响因子：
6.7
通讯作者：
Yeung E
中科院分区：
文献类型：
--
作者：
Buck Louis GM;Bell E;Xie Y;Sundaram R;Yeung E
评估父母健康状况，包括不孕症和婴儿结局。出生队列与父母健康状况和婴儿结局的横断面分析。纽约州北部57个县的父母（n=4,886）和婴儿（n=5,845）参与了纽约州北部儿童出生队列。不孕症的定义为：1)性活跃且无避孕且1年以上未怀孕，2)需要≥12个月才能怀孕，3)指数妊娠需要≥12个月。采用广义估计方程的多变量线性回归估计了婴儿结局（妊娠、出生体重、身长、头围、体重指数）的变化（β系数和95%置信区间（CI）），以及在调整年龄、体重指数和不孕症治疗后与每种疾病（包括不孕症）的关系。父母慢性疾病的患病率从<1%到19%不等，不孕症的患病率为21%到54%。孕妇高血压与妊娠期（β-0.64; 95% CI-1.03,−0.25）和出生体重（−151.98;−262.30,−41.67）呈负相关，哮喘与出生体重（−75.01;−130.40,−19.62）呈负相关。母亲肾脏疾病与较小的头围相关（- 1.09;- 2.17,- 0.01），而父亲自身免疫性疾病与较大的头围相关（0.87;0.15,1.60）。不孕症与出生体重（- 62.18;- 103.78,- 20.58）、体长（- 0.33;- 0.60,- 0.06）和头围（- 0.35;- 0.67,- 0.03）呈负相关。即使在考虑了不孕不育治疗后，不孕不育仍与婴儿尺寸减小显著相关，尽管缩小的幅度因不孕不育的定义而异。在有风险的一年内没有怀孕可能是关于健康的信息。不孕症现在被定义为一种疾病，它与婴儿体型较小有关，特别是当它被定义为怀孕风险持续时间时，其他父母慢性疾病也是如此。
To assess parental health status inclusive of infertility and infant outcomes. Birth cohort with cross-sectional analysis of parental health status and infant outcomes. 57 counties of Upstate New York Parents (n=4,886) and infants (n=5,845) participating in the Upstate KIDS birth cohort. None Infertility was defined as: 1) sexually active without contraception for 1+ years without pregnancy, 2) ever requiring ≥12 months to become pregnant and 3) requiring ≥12 months for index pregnancy. Multivariable linear regression with generalized estimating equations estimated the change (β coefficient and 95% confidence interval (CI)) in infant outcomes (gestation, birthweight, length, head circumference, ponderal index) and relative to each disease, including infertility after adjusting for age, body mass index and infertility treatment. Prevalence of parental chronic diseases ranged from <1% to 19%, and 21% to 54% for infertility. Maternal hypertension was negatively associated with gestation (β-0.64; 95% CI-1.03, −0.25) and birthweight (−151.98; −262.30, −41.67) as was asthma and birthweight (−75.01; −130.40, −19.62). Maternal kidney disease was associated with smaller head circumference (−1.09; −2.17, −0.01), whereas paternal autoimmune disease with larger head circumference (0.87; 0.15, 1.60). Infertility was negatively associated with birthweight (−62.18; −103.78, −20.58), length (−0.33; −0.60, −0.06) and head circumference (−0.35; −0.67, −0.03). Infertility was significantly associated with reduced infant size even after accounting for infertility treatment, though the magnitude of reduction varied by definition of infertility. Absence of pregnancy within a year of being at risk may be informative about health. Infertility, now defined to be a disease, was associated with smaller infant size particularly when defining it as duration at risk for pregnancy, as were other parental chronic diseases.
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