Patel Rita, Tilling Kate, Lawlor Debbie A, Howe Laura D, Bogdanovich Natalia, Matush Lidia, Nicoli Emily, Kramer Michael S, Martin Richard M
School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK.
BMC Public Health. 2014 Sep 8;14:932. doi: 10.1186/1471-2458-14-932.
Socioeconomic disadvantage is associated with shorter adult stature. Few studies have examined socioeconomic differences in stature from birth to childhood and the mechanisms involved, particularly in middle-income former Soviet settings.
The sample included 12,463 Belarusian children (73% of the original cohort) born in 1996-1997, with up to 14 stature measurements from birth to 7 years. Linear spline multi-level models with 3 knots at 3, 12 and 34 months were used to analyse birth length and growth velocity during four age-periods by parental educational achievement (up to secondary school, advanced secondary/partial university, completed university) and occupation (manual, non-manual).
Girls born to the most (versus least) educated mothers were 0.43 cm (95% confidence interval (CI): 0.28, 0.58) longer at birth; for boys, the corresponding difference was 0.30 cm (95% CI: 0.15, 0.46). Similarly, children of the most educated mothers grew faster from birth-3 months and 12-34 months (p-values for trend ≤ 0.08), such that, by age 7 years, girls with the most (versus least) educated mothers were 1.92 cm (95% CI: 1.47, 2.36) taller; after controlling for urban/rural and East/West area of residence, this difference remained at 1.86 cm (95% CI: 1.42, 2.31), but after additionally controlling for mid-parental height, attenuated to 1.10 cm (95% CI: 0.69, 1.52). Among boys, these differences were 1.95 cm (95% CI: 1.53, 2.37), 1.89 cm (95% CI: 1.47, 2.31) and 1.16 cm (95% CI: 0.77, 1.55), respectively. Additionally controlling for breastfeeding, maternal smoking and older siblings did not substantively alter these findings. There was no evidence that the association of maternal educational attainment with growth differed in girls compared to boys (p for interaction = 0.45). Results were similar for those born to the most (versus least) educated fathers, or who had a parent with a non-manual (versus manual) occupation.
In Belarus, a middle-income former Soviet country, socioeconomic differences in offspring growth commence in the pre-natal period and generate up to approximately 2 cm difference in height at age 7 years. These associations are partly explained by genetic or other factors influencing parental stature.
Current Controlled Trials: NCT01352247 assigned 9 Sept 2005; ClinicalTrials.gov. Identifier: NCT01561612 received 20 Mar 2012.
社会经济劣势与成年人身材较矮有关。很少有研究考察从出生到童年时期身高的社会经济差异及其相关机制，尤其是在中等收入的前苏联背景下。
样本包括1996 - 1997年出生的12463名白俄罗斯儿童（占原队列的73%），从出生到7岁最多有14次身高测量数据。采用在3、12和34个月处有3个节点的线性样条多级模型，按父母教育程度（至多中学、高中/部分大学学历、大学学历）和职业（体力劳动者、非体力劳动者）分析四个年龄段的出生身长和生长速度。
母亲受教育程度最高（与最低相比）的女孩出生时身长要长0.43厘米（95%置信区间（CI）：0.28，0.58）；男孩的相应差异为0.30厘米（95% CI：0.15，0.46）。同样，母亲受教育程度最高的孩子在出生至3个月以及12至34个月期间生长更快（趋势p值≤0.08），到7岁时，母亲受教育程度最高（与最低相比）的女孩要高1.92厘米（95% CI：1.47，2.36）；在控制城乡和居住的东/西区因素后，这一差异仍为1.86厘米（95% CI：1.42，2.31），但在进一步控制父母平均身高后，缩小至1.10厘米（95% CI：0.69，1.52）。在男孩中，这些差异分别为1.95厘米（95% CI：1.53，2.37）、1.89厘米（95% CI：1.47，2.31）和1.16厘米（95% CI：0.77，1.55）。进一步控制母乳喂养、母亲吸烟和年长同胞等因素并未实质性改变这些结果。没有证据表明母亲教育程度与生长的关联在女孩和男孩之间存在差异（交互作用p值 = 0.45）。父亲受教育程度最高（与最低相比）的孩子，或父母一方从事非体力（与体力）职业的孩子，结果类似。
在中等收入的前苏联国家白俄罗斯，子代生长的社会经济差异始于产前阶段，到7岁时身高差异可达约2厘米。这些关联部分可由影响父母身高的遗传或其他因素来解释。
当前受控试验：2005年9月9日分配的NCT01352247；ClinicalTrials.gov标识符：2012年3月20日收到的NCT01561612。
