Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, PO Box 855, West Perth WA 6872, Australia.
Int J Environ Res Public Health. 2013 Jun 25;10(7):2606-20. doi: 10.3390/ijerph10072606.
Fetal growth is an important risk factor for infant morbidity and mortality. In turn, socioeconomic status is a key predictor of fetal growth; however, other sociodemographic factors and environmental effects may also be important. This study modelled geographic variation in poor fetal growth after accounting for socioeconomic status, with a fixed effect for socioeconomic status and a combination of spatially-correlated and spatially-uncorrelated random effects. The dataset comprised 88,246 liveborn singletons, aggregated within suburbs in Perth, Western Australia. Low socioeconomic status was strongly associated with an increased risk of poor fetal growth. An increase in geographic variation of poor fetal growth from 1999-2001 (interquartile odds ratio among suburbs = 1.20) to 2004-2006 (interquartile odds ratio = 1.40) indicated a widening risk disparity by socioeconomic status. Low levels of residual spatial patterns strengthen the case for targeting policies and practices in areas of low socioeconomic status for improved outcomes. This study indicates an alarming increase in geographic inequalities in poor fetal growth in Perth which warrants further research into the specific aspects of socioeconomic status that act as risk factors.
胎儿生长是婴儿发病率和死亡率的一个重要危险因素。反过来，社会经济地位是胎儿生长的关键预测因素；然而，其他社会人口因素和环境影响也可能很重要。本研究在考虑社会经济地位的情况下，对胎儿生长不良的地理差异进行建模，固定社会经济地位的影响，并结合空间相关和空间不相关的随机效应。该数据集包括 88246 名在澳大利亚西部珀斯郊区出生的活产 singleton。低社会经济地位与胎儿生长不良的风险增加密切相关。从 1999-2001 年（郊区四分位比的地理变异增加= 1.20）到 2004-2006 年（郊区四分位比= 1.40），胎儿生长不良的地理变异增加表明社会经济地位的风险差距扩大。残留空间模式水平较低，有力地支持了在社会经济地位较低的地区针对政策和实践的目标，以改善结果。本研究表明，珀斯胎儿生长不良的地理不平等现象令人震惊地增加，这需要进一步研究作为风险因素的社会经济地位的具体方面。
