Inequality in infant morbidity: causes and consequences in England in the 1990s
Inequality in infant morbidity: causes and consequences in England in the 1990s
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DOI：
10.1136/jech.52.7.451
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发表时间：
1998-07-01
影响因子：
6.3
通讯作者：
Henderson, J
中科院分区：
文献类型：
--
作者：
Baker, D;Taylor, H;Henderson, J
研究目的：探讨剥夺、拥挤、母亲吸烟、研究目的：探讨母乳喂养对新生儿出生后6个月内喘息和腹泻发病率的影响。研究设计：采用母亲对自我完成问卷的回答进行地理定位的人口调查。研究地点：布里斯托的三个卫生区。研究对象：8501名来自雅芳妊娠和儿童纵向研究（ALSPAC）的婴儿。研究对象为1991年4月至1992年12月在布里斯托待产的所有妇女，主要观察指标为出生后6个月喘息的发生率和严重程度。腹泻的患病率和出生后6个月最严重的一次腹泻的持续时间。结果使用概念层次框架的Logistic回归分析显示，如果婴儿住在租用的住所，他们更有可能报告喘息（OR = 1.20，95%CI = 1.04，1.39）（OR = 1.26，95% CI = 1.06，1.49），如果他们是多个兄弟姐妹之一（OR = 1.78，95% CI = 1.52，2.07），如果他们的母亲吸烟（OR = 1.38，95% CI = 1.21，1.58）。母乳喂养者发生喘息的可能性显著降低（OR = 0.68，95%CI = 0.59，0.79）。这些因素中的每一个都与喘息的患病率独立相关。对于喘息的婴儿，母乳喂养3个月或以上的婴儿在出生后的前6个月内发生3次或3次以上喘息的可能性显著降低（OR = 0.76，95%CI = 0.58，0.99）。婴儿期腹泻的患病率较高与居住在出租房（OR = 1.25，95%CI = 1.10，1.41）和母亲受教育程度较低（OR = 0.76，95%CI = 0.69，0.84）有关，母乳喂养的患病率较低（OR = 0.32，95%CI = 0.37，0.48）。如果一个婴儿住在抵押的房子里，（OR = 1.3495%CI = 1.03，1.75）且母乳喂养3个月或以上（OR = 1.34 95%CI = 1.03，1.75）.结论-在英格兰的这一地理队列中，发育迟缓与常见疾病（如喘息和腹泻）的发病率升高相关在20世纪90年代结果支持的证据表明，母乳喂养是对这些条件的保护，特别是与减少严重程度和持续时间。对未来的研究和政策的影响进行了讨论。
Study objective-To examine the effect of deprivation, crowding, maternal smoking, and breast feeding on morbidity from wheeze and diarrhoea in the first six months after birth.Design-A geographically located population survey using maternal responses on self completion questionnaires.Setting-The three health districts of Bristol.Subjects-8501 infants from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) in which all women expecting a baby between April 1991 and December 1992 in Bristol were invited to participate.Main outcome measures-The prevalence and severity of wheeze at six months after birth. The prevalence of diarrhoea and the duration of the worst bout at six months after birth.Results-Logistic regression analyses using a conceptual hierarchical framework showed that wheeze was significantly more likely to be reported for infants if they lived in rented accommodation (OR = 1.20, 95% CI = 1.04, 1.39), if they lived in crowded housing conditions (OR = 1.26, 95% CI = 1.06, 1.49), if they were one of a number of siblings (OR = 1.78, 95% CI = 1.52, 2.07), and if their mothers smoked (OR = 1.38, 95% CI = 1.21, 1.58). They were significantly less likely to have wheeze if they were breast fed (OR = 0.68, 95% CI = 0.59, 0.79). Each of these factors was independently related to the prevalence of wheeze. For infants with wheeze those who were breast fed for three or more months were significantly less likely to have three or more episodes in the first six months after birth (OR = 0.76, 95% CI = 0.58, 0.99). A higher prevalence of diarrhoea in infancy was associated with living in rented accommodation (OR = 1.25, 95% CI = 1.10, 1.41) and lower maternal education (OR = 0.76, 95% CI = 0.69, 0.84) and a lower prevalence with breast feeding (OR = 0.32, 95% CI = 0.37, 0.48). An episode of diarrhoea was significantly less likely to last for six or more days if an infant Lived in mortgaged accommodation (OR = 1.34 95% CI = 1.03, 1.75) and was breast fed for three or more months (OR = 1.34 95% CI = 1.03, 1.75).Conclusion-Deprivation was associated with heightened morbidity from common conditions such as wheeze and diarrhoea for this geographical cohort of infants in England in the 1990s. Results supported evidence suggesting that breast feeding is protective against such conditions and is particularly associated with reduced severity and duration. Implications for future research and policy are discussed.