Juárez Sol P, Hjern Anders
Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Sveavägen 160, Sveaplan, SE-106 91 Stockholm, Sweden; Stockholm University Demography Unit (SUDA), Department of Sociology, Stockholm University, Universitetsvägen 10, Stockholm, Sweden.
Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institute, Sveavägen 160, Sveaplan, SE-106 91 Stockholm, Sweden; Clinical Epidemiology/Department of Medicine, Karolinska Institute, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden.
Soc Sci Med. 2017 Feb;175:81-90. doi: 10.1016/j.socscimed.2016.12.045. Epub 2016 Dec 30.
In this study we assessed the effect duration of residence on the association between maternal origin and birthweight in Sweden. Considering sibling information, we also investigated how far the presence or lack of such an effect could be biased by the use of cross-sectional data, since there may be a selection among those mothers who decide to have a child soon after moving to the country (e.g. those with a more stable family situation). Using the Swedish Medical Birth Register for the period 1992-2012, we performed linear and multinomial regressions, multilevel linear regressions, and random effect meta-analysis. Offspring of foreign-born mothers were lighter on average (-120 g [-143,-60]) and had a higher risk of having low birthweight (RRR:1.70 [1.61,1.80]) compared to those with Swedish-born mothers. The variation of birthweight by duration of residence was small (less than 50 g) compared to the gradient found between countries grouped according to the human development index (HDI), where the difference between countries with low and very high HDI was of 105 g. Moreover, no clear pattern toward a convergence with the Swedish population was observed after nine years in the country, which was confirmed when we compared the between- and within-mother analyses by HDI categories. Overall, our results support the thesis that contextual early life conditions have an impact on adult health (reproductive health in this case) with consequences in the next generation that cannot be buffered by the situation experienced in the host country.
在本研究中，我们评估了在瑞典居住时长对母亲出生地与出生体重之间关联的影响。考虑到兄弟姐妹的信息，我们还研究了使用横断面数据会在多大程度上使这种效应的存在或缺失产生偏差，因为在那些搬到该国后不久就决定生育孩子的母亲中（例如家庭状况更稳定的母亲）可能存在选择偏倚。我们利用1992年至2012年期间的瑞典医学出生登记数据，进行了线性回归和多项回归、多层次线性回归以及随机效应荟萃分析。与母亲为瑞典出生的后代相比，外国出生母亲的后代平均体重更轻（-120克[-143，-60]），且低出生体重风险更高（相对风险率：1.70[1.61，1.80]）。与根据人类发展指数（HDI）分组的国家之间的梯度相比，出生体重随居住时长的变化较小（小于50克），其中低HDI国家与高HDI国家之间的差异为105克。此外，在该国居住九年后，未观察到与瑞典人群趋同的明显模式，当我们按HDI类别比较母亲之间和母亲内部的分析时，这一点得到了证实。总体而言，我们的结果支持这样一种观点，即早期生活环境会对成年健康（在此为生殖健康）产生影响，并在下一代产生后果，而东道国的经历无法缓冲这种影响。
