At the time of the study, all authors were with the Department of Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison.
Am J Public Health. 2014 Feb;104 Suppl 1(Suppl 1):S81-9. doi: 10.2105/AJPH.2013.301544. Epub 2013 Dec 19.
We sought to determine if and to what extent a woman's exposure to stressful life events prior to conception (PSLEs) were associated with subsequent infant birth weight by using a nationally representative sample of US women.
We examined 9350 mothers and infants participating in the first wave of the Early Childhood Longitudinal Study, Birth Cohort in 2001. Weighted regressions estimated the effect of exposure on very low and low birth weight, adjusting for maternal sociodemographic and health factors and stress during pregnancy.
Twenty percent of women experienced any PSLE. In adjusted analyses, exposed women were 38% more likely to have a very low birth weight infant than nonexposed women. Furthermore, the accumulation of PSLEs was associated with reduced infant birth weight.
This was the first nationally representative study to our knowledge to investigate the impact of PSLEs on very low and low birth weight in the United States. Interventions aimed to improve birth outcomes will need to shift the clinical practice paradigm upstream to the preconception period to reduce women's exposure to stress over the life course and improve the long-term health of children.
本研究旨在利用全美女性的代表性样本，确定女性受孕前的生活应激事件（PSLEs）暴露与随后婴儿出生体重之间的关联及其程度。
我们对 2001 年首次参与“儿童纵向研究早期阶段，出生队列”的 9350 名母亲及其婴儿进行了研究。采用加权回归法，在调整了母亲的社会人口学和健康因素以及孕期压力后，评估了 PSLE 暴露对极低出生体重和低出生体重的影响。
20%的女性经历过任何 PSLEs。在调整后的分析中，与未暴露的女性相比，暴露于 PSLEs 的女性更有可能生育极低出生体重儿。此外，PSLEs 的累积与婴儿出生体重降低有关。
据我们所知，这是第一项针对美国 PSLEs 对极低和低出生体重影响的全国代表性研究。旨在改善出生结局的干预措施需要将临床实践模式转移到受孕前阶段，以减少女性一生中面临的压力，并改善儿童的长期健康。
