Séguin Louise, Xu Qian, Potvin Louise, Zunzunegui Maria-Victoria, Frohlich Katherine L
Department of Social and Preventive Medicine and the Groupe de recherche interdisciplinaire en santé, Université de Montréal, Montréal, Quebec, Canada.
CMAJ. 2003 Jun 10;168(12):1533-8.
Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health.
We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status.
Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3-2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2-2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4-1.2). Household income did not significantly affect the likelihood of an infant having chronic health problems.
Less than sufficient household incomes are associated with poorer overall health and higher hospital admission rates among infants in the first 5 months of life, even after adjustment for factors known to affect infant health, including the mother's level of education.
很少有基于人群的研究分析贫困与婴儿发病率之间的联系。在本研究中,我们想确定收入不足本身是否会对婴儿健康产生影响。
我们采访了参与1998年魁北克儿童发展纵向研究阶段的2223名5个月大儿童的母亲,以确定其婴儿的健康状况以及家庭的社会人口学特征(包括家庭收入、母乳喂养情况和母亲的吸烟习惯)。婴儿出生时的健康数据来自医疗记录。我们使用加拿大统计局对充足收入(高于低收入门槛)、中度不足收入(在低收入门槛的60%至99%之间)和不足收入(低于低收入门槛的60%)的定义,来研究家庭收入对母亲对孩子整体健康的评估、她报告的婴儿慢性健康问题以及她报告的孩子自出生以来住院次数(如有)的影响。在分析中,我们控制了已知会影响婴儿健康的因素:婴儿特征和新生儿健康问题、母亲的教育水平、是否有伴侣、母乳喂养时间以及母亲的吸烟状况。
与收入充足家庭的婴儿相比,收入较低家庭的婴儿更有可能被母亲判定为健康状况不佳(中度不足收入:调整后的优势比[OR]为1.5,95%置信区间[CI]为1.1 - 2.1;非常不足收入:调整后的OR为1.8,95% CI为1.3 - 2.6)。收入中度不足家庭的婴儿比收入充足家庭的婴儿更有可能住院(调整后的OR为1.8,95% CI为1.2 - 2.6),但收入非常不足家庭的婴儿并非如此(调整后的OR为0.7,95% CI为0.4 - 1.2)。家庭收入对婴儿患慢性健康问题的可能性没有显著影响。
即使在对包括母亲教育水平在内的已知会影响婴儿健康的因素进行调整后,家庭收入不足仍与出生后头5个月婴儿的总体健康状况较差和较高的住院率相关。