Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study
Birth weight, childhood socioeconomic environment, and cognitive development in the 1958 British birth cohort study
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DOI：
10.1136/bmj.325.7359.305
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发表时间：
2002-08-10
影响因子：
--
通讯作者：
Hertzman, C
中科院分区：
文献类型：
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作者：
Jefferis, BJMH;Power, C;Hertzman, C
目的研究社会阶层和出生时体重对学龄期认知轨迹的综合影响，以及出生体重与33岁以下受教育程度之间的关系。设计纵向、基于人群的出生队列研究。参与者10845名出生于1958年3月3-9日的男性和女性，其出生体重、社会阶层、和认知测试。主要结果测量阅读，数学，画一个人，复制设计，语言和非语言能力测试在7岁，11岁和16岁，最高资格达到33，结果随着出生体重的增加，儿童期认知测验成绩和学业成绩均显著提高。对7岁时的数学成绩和33岁时取得的最高资格的分析表明，这种关系对潜在的混杂因素的调整是稳健的。出生体重每增加1公斤，男性的数学z得分增加0.17（校正估计值0.15，95%可信区间0.10 ~ 0.21），女性增加0.21（0.20，0.14 ~ 0.25）。7至16岁之间的数学z分数的轨迹分化为不同的社会阶层群体：从I类和II类的参与者增加了他们的相对位置上的分数随着年龄的增长，而类IV和V显示出相对下降，随着年龄的增长。出生体重解释的认知比社会阶层的变化（范围0.5- 1.5%v 2.9-12.5%）。结论出生后的环境有压倒性的影响，通过到成年早期的认知功能，但这些强大的影响并不能解释较弱的，但独立的关联与出生体重。
Objectives To examine the combined effect of social class and weight at birth on cognitive trajectories during school age and the associations between birth weight and educational outcomes through to 33 years.Design Longitudinal, population based, birth cohort study.Participants 10 845 males and females born during 3-9 March 1958 with information on birth weight, social class, and cognitive tests.Main outcome measures Reading, maths, draw a man, copying designs, verbal and non-verbal ability tests at ages 7, 11, and 16, highest qualifications achieved by 33, and trajectories of maths standardised scores at 7-16 years.Results The outcome of all childhood cognitive tests and educational achievements improved significantly with increasing birth weight. Analysis of maths scores at 7 and of highest qualifications achieved by 33 showed that the relations were robust to adjustment for potential confounding factors. For each kilogram increase in birth weight, maths z score increased by 0.17 (adjusted estimate 0.15, 95% confidence interval 0.10 to 0.21) for males and 0.21 (0.20,0.14 to 0.25) for females. Trajectories of maths z scores between 7 and 16 years diverged for different social class groups: participants from classes I and II increased their relative position on the score with increasing age, whereas classes IV and V showed a relative decline with increasing age. Birth weight explained much less of the variation in cognition than did social class (range 0.5-1.5% v 2.9-12.5%).Conclusions The postnatal environment has an overwhelming influence on cognitive function through to early adulthood, but these strong effects do not explain the weaker but independent association with birth weight.