Gissler M, Järvelin M R, Louhiala P, Hemminki E
Health Services Research Unit, National Research and Development Centre for Welfare and Health, Helsinki, Finland.
Acta Paediatr. 1999 Mar;88(3):310-4. doi: 10.1080/08035259950170088.
The purpose of this study was to describe gender differences in children's health until the age of 7 y. The study cohort consisted of all children born in Finland in 1987 (n = 60254), of whom 99.9% were identified in the follow-up. Childhood health data were received from five national registers (1987-94), from regional registers of intellectual disabilities (1987-96) and from education registers in the largest county (1996). Boys had a 20% higher risk for a low 5-min Apgar score and an 11% higher risk for being preterm. After the perinatal period, boys had a 64% higher cumulative incidence of asthma, a 43% higher cumulative incidence of intellectual disability, a 22% higher incidence of mortality and a higher, but not statistically significant, incidence of epilepsy and vision disorders. No male excess was found for diabetes or hearing disorders. The healthcare-related indicators showed poorer health for boys, who had a 37% higher mean of hospital days, a 28% higher risk for receiving social benefits due to health problems and a 13% higher risk for long-term medication. The differences in the socially defined indicators were greatest, and boys had a two- to three-fold risk of having delayed development, postponed school start or attendance in special education programmes. Gender differences in different social classes were similar. Boys' shorter gestational age at birth did not explain the gender differences in childhood health. Some of boys' poorer health seemed to be biologically based, but the social causes of health problems are amenable to change. In particular, the potential of the school system to reduce ill health among boys should be investigated.
本研究的目的是描述7岁前儿童健康方面的性别差异。研究队列包括1987年在芬兰出生的所有儿童（n = 60254），其中99.9%在随访中被识别。儿童健康数据来自五个国家登记处（1987 - 94年）、智力残疾区域登记处（1987 - 96年）以及最大县的教育登记处（1996年）。男孩5分钟阿氏评分低的风险高20%，早产风险高11%。围产期过后，男孩哮喘的累积发病率高64%，智力残疾的累积发病率高43%，死亡率高22%，癫痫和视力障碍的发病率也较高，但无统计学意义。未发现糖尿病或听力障碍方面男性占比过高的情况。与医疗保健相关的指标显示男孩健康状况较差，他们的平均住院天数高37%，因健康问题领取社会福利的风险高28%，长期用药风险高13%。社会定义指标方面的差异最大，男孩出现发育迟缓、推迟上学或参加特殊教育项目的风险是女孩的两到三倍。不同社会阶层的性别差异相似。男孩出生时较短的孕周并不能解释儿童健康方面的性别差异。男孩健康状况较差部分似乎基于生物学因素，但健康问题的社会成因是可以改变的。特别是，应研究学校系统在减少男孩健康不良方面的潜力。
