Eiríksdóttir Védís Helga, Ásgeirsdóttir Tinna Laufey, Bjarnadóttir Ragnheiður Ingibjörg, Kaestner Robert, Cnattingius Sven, Valdimarsdóttir Unnur Anna
Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
PLoS One. 2013 Dec 4;8(12):e80499. doi: 10.1371/journal.pone.0080499. eCollection 2013.
Infants born small for gestational age (SGA) or preterm have increased rates of perinatal morbidity and mortality. Stressful events have been suggested as potential contributors to preterm birth (PB) and low birth weight (LBW). We studied the effect of the 2008 economic collapse in Iceland on the risks of adverse birth outcomes.
The study population constituted all Icelandic women giving birth to live-born singletons from January 1(st) 2006 to December 31(st) 2009. LBW infants were defined as those weighing <2500 grams at birth, PB infants as those born before 37 weeks of gestation and SGA as those with a birth weight for gestational age more than 2 standard deviations (SD's) below the mean according to the Swedish fetal growth curve. We used logistic regression analysis to estimate odds ratios [OR] and corresponding 95 percent confidence intervals [95% CI] of adverse birth outcomes by exposure to calendar time of the economic collapse, i.e. after October 6(th) 2008.
Compared to the preceding period, we observed an increased adjusted odds in LBW-deliveries following the collapse (aOR = 1.24, 95% CI [1.02, 1.52]), particularly among infants born to mothers younger than 25 years (aOR = 1.85, 95% CI [1.25, 2.72]) and not working mothers (aOR = 1.61, 95% CI [1.10, 2.35]). Similarly, we found a tendency towards higher incidence of SGA-births (aOR = 1.14, 95% CI [0.86, 1.51]) particularly among children born to mothers younger than 25 years (aOR = 1.87, 95% CI [1.09, 3.23]) and not working mothers (aOR = 1.86, 95% CI [1.09, 3.17]). No change in risk of PB was observed. The increase of LBW was most distinct 6-9 months after the collapse.
The results suggest an increase in risk of LBW shortly after the collapse of the Icelandic national economy. The increase in LBW seems to be driven by reduced fetal growth rate rather than shorter gestation.
小于胎龄儿（SGA）或早产儿出生时围产期发病率和死亡率较高。应激事件被认为是早产（PB）和低出生体重（LBW）的潜在影响因素。我们研究了冰岛2008年经济危机对不良出生结局风险的影响。
研究对象为2006年1月1日至2009年12月31日期间在冰岛分娩单胎活产儿的所有女性。低出生体重儿定义为出生体重<2500克的婴儿，早产儿定义为妊娠37周前出生的婴儿，小于胎龄儿定义为根据瑞典胎儿生长曲线，出生体重低于孕周平均体重2个标准差（SD）以上的婴儿。我们采用逻辑回归分析，通过暴露于经济危机发生的日历时间（即2008年10月6日之后）来估计不良出生结局的比值比[OR]和相应的95%置信区间[95%CI]。
与之前的时期相比，我们观察到经济危机后低出生体重儿分娩的校正比值增加（校正后比值比[aOR]=1.24，95%CI[1.02,1.52]），特别是在25岁以下母亲所生婴儿中（aOR=1.85，95%CI[1.25,2.72]）以及无工作母亲所生婴儿中（aOR=1.61，95%CI[1.10,2.35]）。同样，我们发现小于胎龄儿出生的发生率有升高趋势（aOR=1.14，95%CI[0.86,1.51]），特别是在25岁以下母亲所生儿童中（aOR=1.87，95%CI[1.09,3.23]）以及无工作母亲所生儿童中（aOR=1.86，95%CI[1.09,3.17]）。未观察到早产风险的变化。低出生体重儿的增加在经济危机后6 - 9个月最为明显。
结果表明冰岛国民经济崩溃后不久低出生体重儿风险增加。低出生体重儿的增加似乎是由胎儿生长速度降低而非孕周缩短所致。
