Childhood Hardship, Maternal Smoking, and Birth Outcomes A Prospective Cohort Study
Childhood Hardship, Maternal Smoking, and Birth Outcomes A Prospective Cohort Study
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DOI：
10.1001/archpediatrics.2010.61
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发表时间：
2010-06-01
影响因子：
--
通讯作者：
Hyppoenen, Elina
中科院分区：
文献类型：
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作者：
Harville, Emily W.;Boynton-Jarrett, Renee;Hyppoenen, Elina
目的：确定童年困难的类型、长期性和严重程度与怀孕期间吸烟状况、早产 (PTB) 和低出生体重 (LBW) 之间的关联。设计：前瞻性队列研究。背景：国家儿童发展研究，一项 1958 年英国出生的全国代表性研究。参与者：4,865 名至少有 1 名单胎活产的妇女。主要暴露：童年时期的困难，由几个变量，包括经济/结构性困难、父母对教育缺乏兴趣、家庭功能障碍、暴力/心理健康问题和家庭结构。主要结果指标：怀孕期间吸烟、低体重和PTB。结果：所有类型的童年困难与怀孕期间吸烟状况之间存在一致且分级的关联（优势比FOR]，4种或更多困难为2.02；95%置信区间[CI]， 1.58-2.58；所有比较 P < .001）。大多数困难还与 LBW 和 PTB 风险相关，在控制吸烟状况和成人社会阶层后，困难次数与两种结果之间的关联仍然存在（LBW，OR，1.51；95% CI，1.10-2.06；PTB，OR，1.44；95% CI，1.08-1.92）。 结论：童年困难对未来怀孕有持久影响结果，部分是通过其与怀孕期间吸烟和成人社会经济地位的关系来确定的。
Objective: To determine the association between type, chronicity, and severity of childhood hardships and smoking status during pregnancy, preterm birth (PTB), and low birth weight (LBW).Design: Prospective cohort study.Setting: The National Child Development Study, a nationally representative study of births in Great Britain in 1958.Participants: Four thousand eight-hundred sixty-five women with at least 1 singleton live birth.Main Exposures: Hardship during childhood, indicated by several variables, including financial/structural hardship, lack of parental interest in education, family dysfunction, violence/mental health issues, and family structure.Main Outcome Measures: Smoking in pregnancy, LBW, and PTB.Results: A consistent and graded association was seen between all types of childhood hardships and smoking status during pregnancy (odds ratio FOR] for 4 or more hardships, 2.02; 95% confidence interval [CI], 1.58-2.58; P < .001 for all comparisons). Most hardships were also associated with risk of LBW and PTB, with associations between number of hardships and both outcomes persisting after controlling for smoking status and adult social class (for LBW, OR, 1.51; 95% CI, 1.10-2.06; for PTB, OR, 1.44; 95% CI, 1.08-1.92).Conclusion: Childhood hardships have an enduring impact on future pregnancy outcomes, in part through their association with smoking during pregnancy and adult socioeconomic position.