Socioeconomic position in early life, birth weight, childhood cognitive function, and adult mortality. A longitudinal study of Danish men born in 1953
Socioeconomic position in early life, birth weight, childhood cognitive function, and adult mortality. A longitudinal study of Danish men born in 1953
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DOI：
10.1136/jech.57.9.681
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发表时间：
2003-09-01
影响因子：
6.3
通讯作者：
Holstein, BE
中科院分区：
文献类型：
--
作者：
Osler, M;Andersen, AMN;Holstein, BE
目的：在考虑出生体重和儿童认知功能的情况下，探讨早期社会经济地位与青年期死亡率的关系。设计：一项与民事登记制度和死亡原因登记相关联的纵向研究。数据采用Cox回归分析。背景：丹麦首都哥本哈根。研究对象：7493名1953年出生的单身男性，他们在12岁时完成了一份包含各种认知测量的调查问卷，并在1965年手工追踪了他们的出生证明和父母特征数据。从1968年4月到2002年1月对这些人群进行了随访，以获取死亡率信息。主要结局指标：各种原因造成的死亡率、心血管疾病和暴力死亡。结果：父亲为工人阶级或出生时社会阶层未知的男性死亡率高于父亲为高/中产阶级的男性：风险比分别为1.39 （95% CI 1.15至1.67）和2.04 （95% CI 1.48至2.83）。出生体重和儿童认知功能均与父亲的社会阶层有关，与全因死亡率呈负相关。父亲的社会阶层与死亡率的相关性减弱(工人阶级为1.30 (1.08 ~ 1.56)；HRunkown等级1.81(1.30至2.52))，出生体重和认知功能。在父亲来自较低社会阶层的男子中，心血管疾病和暴力致死的死亡率也明显较高。结论：在调整出生体重和认知功能后，出生时父亲的社会阶层与成年早期死亡率之间的负相关关系仍然存在，但有所减弱。
Objective: To examine the relation between socioeconomic position in early life and mortality in young adulthood, taking birth weight and childhood cognitive function into account.Design: A longitudinal study with record linkage to the Civil Registration System and Cause of Death Registry. The data were analysed using Cox regression.Setting: The metropolitan area of Copenhagen, Denmark.Subjects: 7493 male singletons born in 1953, who completed a questionnaire with various cognitive measures, in school at age 12 years, and for whom birth certificates with data on birth and parental characteristics had been traced manually in 1965. This population was followed up from April 1968 to January 2002 for information on mortality.Main outcome measures: Mortality from all causes, cardiovascular diseases, and violent deaths.Results: Men whose fathers were working class or of unknown social class at time of birth had higher mortality rates compared with those whose fathers were high/middle class: hazard ratio 1.39 (95% CI 1.15 to 1.67) and 2.04 (95% CI 1.48 to 2.83) respectively. Birth weight and childhood cognitive function were both related to father's social class and inversely associated with all cause mortality. The association between father's social class and mortality attenuated (HRworking class 1.30 (1.08 to 1.56); HRunkown class 1.81 (1.30 to 2.52)) after control for birth weight and cognitive function. Mortality from cardiovascular diseases and violent deaths was also significantly higher among men with fathers from the lower social classes.Conclusion: The inverse association between father's social class at time of birth and early adult mortality remains, however somewhat attenuated, after adjustment for birth weight and cognitive function.