Carlson E, Hoem J M
Department of Sociology, University of South Carolina, Columbia, USA.
Am J Epidemiol. 1999 Mar 1;149(5):447-53. doi: 10.1093/oxfordjournals.aje.a009832.
Analysis of vital statistics for the Czech Republic between 1986 and 1993, including 3,254 infant deaths from 350,978 first births to married and single women who conceived at ages 18-29 years, revealed a neonatal survival advantage for low-weight infants born to disadvantaged (single, less educated) women, particularly for deaths from congenital anomalies. This advantage largely disappeared after the neonatal period. The same patterns have been observed for low-weight infants born to black women in the United States. Since the Czech Republic had an ethnically homogenous population, virtually universal prenatal care, and uniform institutional conditions for delivery, Czech results must be attributed to social rather than to biologic or medical circumstances. This strengthens the contention that in the United States, the black neonatal survival paradox may be due as much to race-related social stigmatization and consequent disadvantage as to any hypothesized hereditary influences on birth-weight-specific survival.
对1986年至1993年捷克共和国的人口动态统计数据进行分析，这些数据涵盖了18至29岁怀孕的已婚和单身女性的350,978例头胎生育中的3254例婴儿死亡情况。分析发现，处于弱势地位（单身、受教育程度较低）的女性所生育的低体重婴儿在新生儿期具有生存优势，尤其是在因先天性异常导致的死亡方面。这种优势在新生儿期之后基本消失。在美国，黑人女性所生育的低体重婴儿也观察到了同样的模式。由于捷克共和国人口种族单一，几乎全民享有产前护理，且分娩的制度条件统一，因此捷克的研究结果必定归因于社会因素，而非生物或医学因素。这强化了一种观点，即在美国，黑人新生儿生存悖论可能同样归因于与种族相关的社会污名化以及由此产生的劣势，而非任何关于出生体重特异性生存的假设性遗传影响。
