Fetal health stagnation: Have health conditions in utero improved in the United States and Western and Northern Europe over the past 150 years?
Fetal health stagnation: Have health conditions in utero improved in the United States and Western and Northern Europe over the past 150 years?
复制标题
胎儿健康停滞：过去 150 年来，美国、西欧和北欧的子宫内健康状况是否有所改善？
DOI：
10.1016/j.socscimed.2017.02.018
复制
发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Schneider EB
中科院分区：
文献类型：
--
作者：
Schneider EB
许多实证研究表明，子宫内的健康状况可能会对整个生命过程的健康产生长期持久的影响。然而，尽管有这些证据，关于胎儿健康在很长一段时间内发生了怎样的变化，并没有明确的共识。本文分析了历史出生体重和围产儿死亡率，以构建一幅关于子宫健康状况在过去150年中如何变化的连贯图景。简而言之，证据表明，胎儿健康相对停滞不前。关于出生体重的有限证据表明，到19世纪末，北美和北欧和西欧的出生体重已经达到目前的水平，而且在这两者之间几乎没有变化。自20世纪30年代末以来，围产期死亡率大幅下降，但这一下降主要是由于引入磺胺类药物和抗生素后，分娩期间治疗有所改善。因此，与围产期死亡率下降相关的健康益处集中在高危人群中，并不影响整个人口。在许多其他健康指标大幅改善的情况下发现胎儿健康停滞不前是具有挑衅性的，并提出了两个结论：要么是胎儿健康没有改善，要么是用于衡量胎儿健康的指标--今天仍在广泛使用的指标--可能无法准确反映健康子宫的所有方面。如果胎儿健康一直停滞不前，那么子宫条件的改善不能解释20世纪预期寿命的队列改善。如果胎儿健康的指标有问题，那么研究人员必须超越出生体重和围产期死亡率，以了解基于产前环境的发育可塑性如何影响未来的健康。
Many empirical studies have shown that health conditionsin uterocan have long lasting consequences for health across the life course. However, despite this evidence, there is no clear consensus about how fetal health has changed in the very long run. This paper analyses historical birth weights and perinatal mortality rates to construct a coherent picture of how health conditionsin uterohave changed over the past 150 years. In short, the evidence suggests that fetal health has been relatively stagnant. Limited evidence on birth weights shows that they had already reached their current levels in North America and Northern and Western Europe by the late nineteenth century, and they have changed very little in between. Perinatal mortality rates have fallen dramatically since the late 1930s, but this decline was mainly caused by improvements in intrapartum treatments after the introduction of Sulfa drugs and antibiotics. Thus, the health benefits associated with the perinatal mortality decline were concentrated among those at risk and did not influence the population at large. Finding stagnant fetal health during a period when many other indicators of health improved dramatically is provocative and suggests two conclusions: either fetal health did not improve or the indicators used to measure fetal health, indicators still widely used today, may not accurately capture all aspects of healthin utero. If fetal health has been stagnant, then better conditionsin uterocannot explain cohort improvements in life expectancy over the twentieth century. If the indicators of fetal health are problematic, then researchers must move beyond birth weight and perinatal mortality to understand how developmental plasticity based on the prenatal environment influences later life health.
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影响因子：
5.1
作者：
Kramer, MS;Morin, I;Wen, SW
通讯作者：
Wen, SW
影响因子：
7.7
作者：
Wilcox, AJ
通讯作者：
Wilcox, AJ
起点：出生体重和生命机会
DOI：
--
发表时间：
2003
期刊：
影响因子：
--
作者：
D. Conley;Kate W. Strully;N. Bennett
通讯作者：
N. Bennett
出生体重作为人类福利的指标
DOI：
--
发表时间：
2016
期刊：
影响因子：
--
作者：
W. Ward
通讯作者：
W. Ward
出生体重和经济增长：工业化西方的妇女生活水平。
DOI：
10.2307/2081527
发表时间：
1994
期刊：
The Journal of American History
影响因子：
--
作者：
Daniel Scott Smith;W. Ward
通讯作者：
W. Ward