Grjibovski Andrej M, Bygren Lars O, Svartbo Boo, Magnus Per
Department of Community Medicine and Rehabilitation, Social Medicine, University of Umeå, Sweden.
Ann Epidemiol. 2003 Oct;13(9):599-605. doi: 10.1016/S1047-2797(03)00052-8.
The study examines variations in fetal growth by maternal social circumstances in a Russian town.
All pregnant women registered at the antenatal clinics in 1999 in Severodvinsk (north-west Russia) and their live born infants comprised the study base (n=1399). Multivariate linear regression analysis was applied to quantify the effect of socio-demographic factors on birthweight and the ponderal index (PI).
A clear gradient of birthweight in relation to mothers' education was revealed. Babies of the most educated mothers were 207 g (95% CI, 55, 358) heavier than babies of mothers with basic education. The average weight of those born to mothers with secondary and vocational levels of education was 172 g (95% CI, 91, 253) and 83 g (95% CI, 9, 163) lower compared with infants born to mothers with a university level of education after adjustment for age, parity, pre-pregnancy weight, marital status, maternal occupation, length of gestation, and sex of the baby. Maternal education also influenced the PI.
Further studies should focus on the mechanisms of the coherence of maternal education and fetal growth. To ensure that all parts of the society benefit equally from economic and social reforms, social variations in pregnancy outcomes should be monitored during the time of transition.
本研究考察俄罗斯一个城镇中，胎儿生长因母亲社会状况不同而产生的差异。
1999年在俄罗斯西北部北德文斯克市产前诊所登记的所有孕妇及其活产婴儿构成了研究样本（n = 1399）。采用多元线性回归分析来量化社会人口学因素对出生体重和 ponderal 指数（PI）的影响。
研究揭示了出生体重与母亲教育程度之间明显的梯度关系。受过高等教育母亲所生的婴儿比只接受过基础教育母亲所生的婴儿重207克（95%可信区间，55, 358）。在对年龄、胎次、孕前体重、婚姻状况、母亲职业、妊娠时长和婴儿性别进行调整后，与受过大学教育母亲所生婴儿相比，接受中等教育和职业教育母亲所生婴儿的平均体重分别低172克（95%可信区间，91, 253）和83克（95%可信区间，9, 163）。母亲教育程度也对PI有影响。
进一步的研究应聚焦于母亲教育程度与胎儿生长之间关联的机制。为确保社会各阶层能平等地从经济和社会改革中受益，在转型期应监测妊娠结局的社会差异。
