Department of Social Medicine, National Research Institute for Child Health and Development, National Center for Child Health and Development, 2-10-1, Setagaya-ku, Tokyo, Japan.
BMC Public Health. 2013 Apr 25;13:389. doi: 10.1186/1471-2458-13-389.
Research investigating the association between socioeconomic status (SES) and blood pressure (BP) during pregnancy is limited and its underlying pathway is unknown. The aim of this study was to investigate the mediators of the association between educational level as an indicator of the SES and BP in early and mid-pregnancy among Japanese women.
Nine hundred and twenty-three pregnant women in whom BP was measured before 16 weeks and at 20 weeks of gestation were enrolled in this study. Maternal educational levels were categorized into three groups: high (university or higher), mid (junior college), and low (junior high school, high school, or vocational training school).
The low educational group had higher systolic (low vs. high, difference = 2.39 mmHg, 95% confidence interval [CI]: 0.59 to 4.19) and diastolic BP levels (low vs. high, difference = 0.74 mmHg, 95% CI: -0.52 to 1.99) in early pregnancy. However, the same associations were not found after adjustment for pre-pregnancy body mass index (BMI). BP reduction was observed in mid-pregnancy in all three educational groups and there was no association between educational level and pregnancy-induced hypertension.
In Japanese women, the low educational group showed higher BP during pregnancy than the mid or high educational groups. Pre-pregnancy BMI mediates the association between educational level and BP.
关于社会经济地位（SES）与妊娠期间血压（BP）之间关联的研究有限，其潜在途径尚不清楚。本研究旨在探讨以教育水平作为 SES 指标与日本女性妊娠早期和中期 BP 之间关联的中介因素。
本研究纳入了 923 名在妊娠 16 周前和 20 周时测量血压的孕妇。将母亲的教育水平分为三组：高（大学或以上）、中（大专）和低（初中、高中或职业培训学校）。
低教育组在妊娠早期的收缩压（低 vs. 高，差异=2.39mmHg，95%置信区间[CI]：0.59 至 4.19）和舒张压水平（低 vs. 高，差异=0.74mmHg，95%CI：-0.52 至 1.99）更高。然而，在校正孕前体重指数（BMI）后，这些关联不再存在。在妊娠中期，所有三组的 BP 均有所下降，且教育水平与妊娠高血压之间无关联。
在日本女性中，低教育组在怀孕期间的 BP 高于中或高教育组。孕前 BMI 介导了教育水平与 BP 之间的关联。
