On the importance - and the unimportance - of birthweight
On the importance - and the unimportance - of birthweight
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DOI：
10.1093/ije/30.6.1233
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发表时间：
2001-12-01
影响因子：
7.7
通讯作者：
Wilcox, AJ
中科院分区：
文献类型：
--
作者：
Wilcox, AJ
体重是流行病学中最容易理解和最容易被误解的变量之一。婴儿出生时的体重与第一次分娩时的死亡风险密切相关！年，A。程度较轻，儿童期有发育问题，成年后有患各种疾病的风险。流行病学分析通常认为出生体重是导致这些健康结果的原因。在这种因果关系假设下，出生体重被用来解释婴儿死亡率和后来发病率的变化，本身也被用作中间健康终点。这里提出的证据表明，出生体重和健康结果之间的联系可能不是因果关系。假设因果关系的分析方法往好里说是不可靠的，往坏里说是有偏见的。特别是“低出生体重”这一类别缺乏信息，而且很少有理由。出生体重分布的主要用途是提供一个估计的比例小早产在人口（虽然即使这需要特殊的分析方法）。虽然出生体重的普通方法没有很好的基础，出生体重和一系列健康结果之间的联系可能反映了生物机制的运作，对人类健康的影响。
Birthweight is one of the most accessible and most misunderstood variables in epidemiology. A baby's weight at birth is strongly associated with mortality risk during the first! year and, to a. lesser degree, with developmental problems in childhood and the risk of various diseases in adulthood. Epidemiological analyses often regard birthweight as on the causal pathway to these health outcomes. Under this assumption of causality, birthweight is used to explain variations in infant mortality and later morbidity, and is also used as an intermediate health endpoint in itself. Evidence presented here suggests the link between birthweight and health outcomes may not be causal. Methods of analysis that assume causality are unreliable at best, and biased at worst. The category of 'low birthweight' in particular is uninformative and seldom justified. The main utility of the birthweight distribution is to provide an estimate of the proportion of small preterm births in a population (although even this requires special analytical methods). While the ordinary approaches to birthweight are not well grounded, the links between birthweight and a range of health outcomes may nonetheless reflect the workings of biological mechanisms with implications for human health.