Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence.
Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence.
复制标题
兄弟姐妹之间共有的未测量的特征混淆了阿普加评分与青春期压力恢复能力的关联。
DOI：
10.1111/apa.14881
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Bergh C
中科院分区：
文献类型：
--
作者：
Bergh C
目的：探讨低Apgar评分及其他围产期特征与青春期应激恢复能力低的关系。兄弟姐妹内部分析用于解决未测量的共享家族混淆。方法：研究对象为1973年至1992年间出生在瑞典的527763名男性，平均年龄为18岁（17-20岁）。征兵检查包括压力恢复能力的测量。有关Apgar评分和其他围产期特征的信息是通过与医疗出生登记册的联系获得的。使用普通最小二乘法和固定效应线性回归模型进行分析，调整了潜在的混杂因素。结果5分钟Apgar评分较低的婴儿与1分钟评分最高的婴儿相比，其青春期压力恢复能力低的风险增加，调整系数和95%置信区间为- 0.26（- 0.39,- 0.13）。当使用兄弟姐妹模型时，这些关联不再具有统计学意义。然而，在所有的分析中，应激恢复力和出生体重的关联仍然具有统计学意义。结论低出生体重与低应激恢复力独立相关，而低出生体重与低应激恢复力独立相关。
AimWe investigated the association between low Apgar score, other perinatal characteristics and low stress resilience in adolescence. A within‐siblings analysis was used to tackle unmeasured shared familial confounding.MethodsWe used a national cohort of 527 763 males born in Sweden between 1973 and 1992 who undertook military conscription assessments at mean age of 18 years (17–20). Conscription examinations included a measure of stress resilience. Information on Apgar score and other perinatal characteristics was obtained through linkage with the Medical Birth Register. Analyses were conducted using ordinary least squares and fixed‐effects linear regression models adjusted for potential confounding factors.ResultsInfants with a prolonged low Apgar score at five minutes had an increased risk of low stress resilience in adolescence compared with those with highest scores at one minute, with an adjusted coefficient and 95% confidence interval of −0.26 (−0.39, −0.13). The associations were no longer statistically significant when using within‐siblings models. However, the associations with stress resilience and birthweight remained statistically significant in all analyses.ConclusionThe association with low Apgar score seems to be explained by confounding due to shared childhood circumstances among siblings from the same family, while low birthweight is independently associated with low stress resilience.