a Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh , Pittsburgh , USA.
b Department of Epidemiology, School of Public Health, University of Washington , Seattle , USA.
Ethn Health. 2019 Oct;24(7):829-840. doi: 10.1080/13557858.2017.1378804. Epub 2017 Sep 19.
To examine the association of maternal low birthweight (LBW) with infant LBW and infant LBW subgroups (i.e. moderate and very LBW), overall and among non-Hispanic (NH) white and NH black mothers. We conducted a population-based cohort study in Allegheny County, Pennsylvania, using linked birth record data of NH white and NH black mother-infant pairs ( = 6,633) born in 1979-1998 and 2009-2011, respectively. The exposure of interest was maternal LBW (birthweight <2500 grams) while the outcomes were infant LBW and LBW subgroups - moderate LBW (1,500-2,499 grams) or very LBW (<1,500 grams). Logistic regression (binomial and multinomial) models were used to estimate adjusted Odds Ratios (ORs), Relative Risk Ratios (RRRs), and related 95% confidence intervals (CI). Stratified analyses were conducted to assess effect modification by mothers' race. Maternal LBW was associated with 1.53 (95%CI: 1.15-2.02) and 1.75 (95%CI: 1.29-2.37) -fold increases in risk of infant LBW and MLBW, respectively, but not VLBW (RRR = 0.86; 95%CI: 0.44-1.70). In race-stratified models, maternal LBW-infant LBW associations were observed among NH blacks (OR = 1.88; 95%CI: 1.32-2.66) and not among NH whites (OR = 1.03; 95%CI: 0.62-1.73) (P for interaction = 0.07). Among NH blacks, maternal LBW was associated with a 2.18 (95%CI: 1.49, 3.20) -fold increase in risk of infant MLBW, but not VLBW (RRR = 1.12; 95%CI: 0.54, 2.35). Among NH whites, LBW subgroup analyses could not be performed due to small numbers of VLBW infants among LBW mothers. Mothers who were LBW at their own birth were more likely to have MLBW infants. Maternal race modified associations of maternal LBW with infant LBW, particularly infant MLBW. Further research is needed in this area to understand the potential mechanisms involved in the transgenerational transmission of LBW risk and race-specific differences in the transmission.
为了研究母亲低出生体重(LBW)与婴儿 LBW 及婴儿 LBW 亚组(即中度和重度 LBW)之间的关联,我们在宾夕法尼亚州阿勒格尼县进行了一项基于人群的队列研究,使用了分别于 1979 年至 1998 年和 2009 年至 2011 年出生的非西班牙裔(NH)白人和 NH 黑人生育记录数据,对 NH 白人和 NH 黑人母婴对( = 6633)进行了关联。感兴趣的暴露因素是母亲 LBW(出生体重<2500 克),而结局是婴儿 LBW 和 LBW 亚组-中度 LBW(1500-2499 克)或重度 LBW(<1500 克)。使用逻辑回归(二项式和多项式)模型来估计调整后的优势比(ORs)、相对风险比(RRRs)和相关的 95%置信区间(CI)。进行分层分析以评估母亲种族对效应修饰的影响。母亲 LBW 与婴儿 LBW 的风险分别增加 1.53 倍(95%CI:1.15-2.02)和 1.75 倍(95%CI:1.29-2.37),但与重度 LBW 无关(RRR=0.86;95%CI:0.44-1.70)。在按种族分层的模型中,在 NH 黑人中观察到母亲 LBW-婴儿 LBW 之间的关联(OR=1.88;95%CI:1.32-2.66),而在 NH 白人中则没有(OR=1.03;95%CI:0.62-1.73)(P 交互=0.07)。在 NH 黑人中,母亲 LBW 与婴儿中度 LBW 的风险增加 2.18 倍(95%CI:1.49,3.20)有关,但与重度 LBW 无关(RRR=1.12;95%CI:0.54,2.35)。在 NH 白人中,由于 LBW 母亲中重度 LBW 婴儿的数量较少,因此无法进行 LBW 亚组分析。在出生时体重不足的母亲更有可能生育中度 LBW 婴儿。母亲种族改变了母亲 LBW 与婴儿 LBW 之间的关联,尤其是婴儿中度 LBW。在这一领域需要进一步研究,以了解 LBW 风险的跨代传播和传播中特定种族差异所涉及的潜在机制。