Grjibovski Andrej, Bygren Lars Olov, Svartbo Boo, Magnus Per
Unit for Preventive Nutrition, Department of Biosciences at NOVUM, Karolinska Institutet, Huddinge, Sweden.
Acta Obstet Gynecol Scand. 2004 Dec;83(12):1159-66. doi: 10.1111/j.0001-6349.2004.00443.x.
Social determinants of health have become important in countries of the former Soviet Union during the time of transition.
This article estimates the influence of living conditions, smoking, alcohol, and maternal stress on fetal growth indices in an urban Russian setting.
All pregnant women registered at antenatal care centres in Severodvinsk (Northwest Russia) and their infants comprised the study base (n = 1399). Multivariate linear regression analysis was applied to quantify the effects of the studied factors on birth weight and the ponderal index (PI) adjusted for maternal education, age, occupation, marital status, parity, pre-pregnancy weight, paternal employment, gestational age, and others.
Infants of smoking mothers were 126 g lighter compared with non-smokers [95% confidence interval (CI): -198; -54]. On average, birth weight decreased 27 g per cigarette smoked during pregnancy. Living in shared apartments, living in crowded housing situations, and perceived stress were associated significantly with birth weight loss: -89 g (95% CI: -153; -25), -82 g (95% CI: -136; -28), and -61 g (95% CI: -116; -7), respectively. A positive association between maternal alcohol consumption and birth weight was found. Living with parents was associated positively with both birthweight and PI. Infants whose fathers consumed more than 100 ml of absolute alcohol per week were thinner at birth compared with those of non-drinking and moderate drinking fathers.
Poor housing conditions, maternal stress, smoking, and alcohol consumption are independent determinants of fetal growth in Northwest Russia.
在前苏联国家的转型时期，健康的社会决定因素变得至关重要。
本文评估了俄罗斯城市环境中生活条件、吸烟、饮酒和母亲压力对胎儿生长指标的影响。
在俄罗斯西北部北德文斯克的产前护理中心登记的所有孕妇及其婴儿构成了研究样本（n = 1399）。应用多元线性回归分析来量化所研究因素对出生体重和经产妇教育程度、年龄、职业、婚姻状况、产次、孕前体重、父亲就业情况、孕周等因素调整后的 ponderal 指数（PI）的影响。
吸烟母亲的婴儿比不吸烟母亲的婴儿轻 126 克[95%置信区间（CI）：-198；-54]。孕期平均每吸一支烟，出生体重下降 27 克。居住在合住公寓、居住环境拥挤以及感知到的压力与出生体重减轻显著相关：分别为-89 克（95%CI：-153；-25）、-82 克（95%CI：-136；-28）和-61 克（95%CI：-116；-7）。发现母亲饮酒与出生体重呈正相关。与父母同住与出生体重和 PI 均呈正相关。父亲每周饮用超过 100 毫升纯酒精的婴儿出生时比不饮酒和适度饮酒父亲的婴儿更瘦。
恶劣的住房条件、母亲压力、吸烟和饮酒是俄罗斯西北部胎儿生长的独立决定因素。
