Morton Susan M B, De Stavola Bianca L, Leon David A
Centre for Longitudinal Research & School of Population Health, University of Auckland, Auckland, New Zealand and London School of Hygiene & Tropical Medicine, London, UKCentre for Longitudinal Research & School of Population Health, University of Auckland, Auckland, New Zealand and London School of Hygiene & Tropical Medicine, London, UK
Centre for Longitudinal Research & School of Population Health, University of Auckland, Auckland, New Zealand and London School of Hygiene & Tropical Medicine, London, UK.
Int J Epidemiol. 2014 Jun;43(3):749-59. doi: 10.1093/ije/dyu028. Epub 2014 Feb 25.
Size at birth has taken on renewed significance due to its now well-established association with many health and health-related outcomes in both the immediate perinatal period and across the entire life course. Optimizing fetal growth to improve both neonatal survival and population health is the focus of much research and policy development, although most efforts have concentrated on either the period of pregnancy itself or the period immediately preceding it.
Intergenerational data linked to the Aberdeen Children of the 1950s (ACONF) study were used to examine the influence of grandparental and parental life course biological and social variables on the distribution of offspring size at birth. Guided stepwise multivariable methods and a graphical approach were used to assess the relative importance of these temporally ordered and highly correlated life course measures.
Both distal and proximal grandparental and parental life course biological and social factors predicted offspring size at birth. Inequalities in size at birth, according to adult maternal socioeconomic indicators, were found to be largely generated by the continuity of the social environment across generations, and the inequalities in maternal early life growth were predicted by the adult grandparental social environment during the mother's early life. Mother's own size at birth predicted her offspring's intrauterine growth, independent of her adult biological and social characteristics.
A mother's childhood social environment and her early growth are both important predictors of her offspring's size at birth. Population strategies aimed at optimizing size at birth require broader social and intergenerational considerations, in addition to focusing on the health of mothers in the immediate pregnancy period.
出生时的体型具有了新的重要意义，因为现在已经明确其与围产期即刻以及整个生命过程中的许多健康及与健康相关的结局存在关联。优化胎儿生长以提高新生儿存活率和改善人群健康是许多研究和政策制定的重点，尽管大多数努力都集中在孕期本身或紧接孕期之前的时期。
利用与20世纪50年代阿伯丁儿童（ACONF）研究相关的代际数据，来检验祖父母和父母生命历程中的生物学和社会变量对后代出生时体型分布的影响。采用逐步多变量方法和图形方法来评估这些按时间顺序排列且高度相关的生命历程指标的相对重要性。
祖父母和父母生命历程中的远端和近端生物学及社会因素均能预测后代出生时的体型。根据成年母亲的社会经济指标，出生时体型的不平等很大程度上是由社会环境的代际连续性造成的，而母亲早年生长的不平等则由母亲早年的成年祖父母社会环境所预测。母亲自身出生时的体型可预测其后代的宫内生长情况，且不受其成年时的生物学和社会特征影响。
母亲童年的社会环境及其早期生长都是其后代出生时体型的重要预测因素。旨在优化出生时体型的人群策略除了关注孕期母亲的健康外，还需要更广泛的社会和代际考量。
