School of Population Health, University of Queensland, Brisbane, Australia.
Int J Epidemiol. 2009 Oct;38(5):1390-400. doi: 10.1093/ije/dyp252. Epub 2009 Jul 27.
The nature of the association between birth weight and behavioural problems in adolescence is unclear. Recent studies are limited by their capacity to adjust for important obstetric and measurement issues. Aim To examine the nature of the association between birth weight and a range of behavioural symptoms, including anxiety/depression and social problems, in adolescence.
Data from 4971 mothers and their children participating in the Mater University Study of Pregnancy (MUSP), a prospective, population-based birth cohort, are presented. This study commenced in Brisbane, Australia, in 1981. Mothers and their children were followed up at 3-5 days post-birth, and 6 months, 5 years and 14 years after the initial interview. Internalizing and externalizing behaviour problems, social problems and anxiety/depressive symptoms were assessed using Achenbach's Youth Self Report (YSR) of the Child Behaviour Check List (CBCL).
There was no evidence of a linear association between birth weight and behavioural symptoms, when birth weight z-scores were examined as a continuous variable. However, a non-linear association was identified when birth weight z-scores were categorized into quintiles. Children in the lowest and highest quintiles were at higher risk of increased anxiety/depressive and social problems symptoms. After adjustment for potential confounders, birth weight showed a non-linear association with the log odds of social problems {Quintile 1 odds ratio (OR) 1.59 [95% confidence interval (CI) 1.13, 2.23] Quintile 5 OR 1.57 (95% CI 1.12, 2.20)}.
Our findings provide further support for an association between birth weight and some adolescent behaviour problems. This association is likely to be non-linear, affecting babies at both the lower and higher ends of the birth weight distribution.
出生体重与青少年行为问题之间的关联性质尚不清楚。最近的研究受到其调整重要产科和测量问题能力的限制。目的：研究出生体重与一系列行为症状（包括焦虑/抑郁和社会问题）在青少年时期之间的关联性质。
本研究使用来自 4971 名母亲及其参与 Mater 大学妊娠研究（MUSP）的孩子的数据，这是一项前瞻性的基于人群的出生队列研究。该研究于 1981 年在澳大利亚布里斯班开始。母亲及其孩子在出生后 3-5 天、6 个月、5 岁和 14 岁时进行了随访。使用 Achenbach 的儿童行为检查表（CBCL）中的青少年自我报告（YSR）评估内化和外化行为问题、社会问题和焦虑/抑郁症状。
当将出生体重 z 分数作为连续变量检查时，出生体重与行为症状之间没有线性关联的证据。然而，当将出生体重 z 分数分类为五分位数时，发现了非线性关联。最低和最高五分位数的儿童出现焦虑/抑郁和社会问题症状增加的风险更高。在校正潜在混杂因素后，出生体重与社会问题的对数比值呈非线性关联{五分位数 1 的比值比（OR）为 1.59（95%置信区间（CI）为 1.13,2.23）五分位数 5 的 OR 为 1.57（95% CI 为 1.12,2.20）}。
我们的研究结果为出生体重与一些青少年行为问题之间的关联提供了进一步的支持。这种关联可能是非线性的，影响出生体重分布较低和较高端的婴儿。
