双胞胎的出生与父母离婚之间的关联。
Association between the birth of twins and parental divorce.
机构信息
From the Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Wang Ambulatory Care Center, Boston, Massachusetts; and the Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California.
出版信息
Obstet Gynecol. 2011 Apr;117(4):892-897. doi: 10.1097/AOG.0b013e3182102adf.
OBJECTIVE
Mothers of multiple births face higher rates of postpartum depression, yet evidence on the marital consequences of multiple births is limited. We examined the association between twin births and parental divorce.
METHODS
We used the 1980 U.S. Census to identify a large sample of mothers with and without twin births. The goal was to estimate multivariate logistic models of the association between birth of twins and divorce adjusting for race, age at marriage and first birth, and college education. We examined whether the association was affected by maternal education, age and sex composition of twins, and family size.
RESULTS
Twins at first birth were associated with greater parental divorce compared with singletons (odds ratio, 1.08; 95% confidence interval, 1.01-1.16; absolute risk 13.7% with twins compared with 12.7%; P=.02). The association was statistically greater among mothers not attending college (14.9% with twins compared with 13.3%; P=.01) compared with those with some college (10.4% with twins compared with 10.5%; P=.34); those with children older than 8 years (15.6% with twins compared with 13.5%; P<.01) compared with younger children (10.6% with twins compared with 10.8%; P=.42); and those with at least one twin girl (13.8% with twins compared with 12.6%; P=.03) compared with twin boys (12.1% with twins compared with 12.5%, P=.38). Mothers with four or more children had a larger association between birth of twins and divorce (15.4% for mothers with twins at fourth birth compared with 11.3% for all other mothers with four or more children; P<.01) compared with mothers with twins at first birth (13.7% for twins at first birth compared with 12.7%; P=.02).
CONCLUSION
Health consequences of twin births for children and mothers are well known. Twin births may be associated with longer-term parental divorce. Specific groups, namely mothers not completing college and mothers who already have more children, may be at higher risk.
LEVEL OF EVIDENCE
II.
目的
多胎母亲产后抑郁的发生率较高，但多胎出生的婚姻后果证据有限。我们研究了双胞胎出生与父母离婚之间的关系。
方法
我们使用 1980 年美国人口普查数据，确定了一组较大的有双胞胎和无双胞胎出生的母亲样本。目的是通过调整种族、初婚年龄和初育年龄、以及大学教育程度，估计多变量逻辑模型来评估双胞胎出生与离婚之间的关联。我们还研究了母亲教育程度、双胞胎的年龄和性别构成以及家庭规模是否会影响这种关联。
结果
与单胎相比，首次生育双胞胎与父母离婚的相关性更高（比值比，1.08；95%置信区间，1.01-1.16；双胞胎的绝对风险为 13.7%，单胎的绝对风险为 12.7%；P=0.02）。在未接受大学教育的母亲中，这种关联更为显著（双胞胎的比例为 14.9%，单胎的比例为 13.3%；P=0.01），而在接受过一些大学教育的母亲中，这种关联则不显著（双胞胎的比例为 10.4%，单胎的比例为 10.5%；P=0.34）；在孩子年龄大于 8 岁的母亲中，这种关联更为显著（双胞胎的比例为 15.6%，单胎的比例为 13.5%；P<.01），而在年龄较小的孩子中，这种关联则不显著（双胞胎的比例为 10.6%，单胎的比例为 10.8%；P=0.42）；在至少有一个双胞胎女孩的母亲中，这种关联更为显著（双胞胎的比例为 13.8%，单胎的比例为 12.6%；P=0.03），而在双胞胎男孩的母亲中，这种关联则不显著（双胞胎的比例为 12.1%，单胎的比例为 12.5%；P=0.38）。在有 4 个或更多孩子的母亲中，双胞胎出生与离婚的关联更大（第四次生育有双胞胎的母亲的比例为 15.4%，而所有其他有 4 个或更多孩子的母亲的比例为 11.3%；P<.01），而与首次生育双胞胎的母亲相比（首次生育双胞胎的比例为 13.7%，单胎的比例为 12.7%；P=0.02），这种关联则较小。
结论
双胞胎出生对儿童和母亲的健康后果是众所周知的。双胞胎出生可能与父母离婚的长期风险有关。特定群体，即未完成大学学业的母亲和已经有更多孩子的母亲，可能面临更高的风险。
证据等级
II 级。
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