Kane Jennifer B, Margerison-Zilko Claire
Department of Sociology, University of California, Irvine, Irvine, CA 92697.
Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824.
Popul Res Policy Rev. 2017 Oct;36(5):639-669. doi: 10.1007/s11113-017-9430-8. Epub 2017 Mar 9.
Recent efforts to explain the stark social and racial disparities in adverse birth outcomes that have persisted for decades in the U.S. have looked beyond prenatal factors, to explore preconception social conditions that may influence perinatal health via dysregulation of physiologic processes. The extant evidence supporting this link however remains limited, both due to a lack of data and theory. To address the latter, this manuscript generates a structured set of theoretical insights that further develop the link between two preconception social conditions - place and social relationships - and perinatal health. The insights propose the following.
necessarily encompasses all social contexts to which females are exposed from infancy through young adulthood; encompasses a variety of related exposures that, when possible, should be jointly considered; and may compound the effect of poverty-in childhood, adolescence, or young adulthood-on perinatal health. Social relationships: span relationships from early life through adulthood, and extend to intergenerational associations; often involve (or induce) major changes in the lives of individuals and should be examined with an emphasis on the developmental stage in which the change occurred; and necessarily encompass a lack of social integration, or, social isolation. We also identify potential biological and social-structural mechanisms linking these preconception social conditions to perinatal health, and conclude by identifying promising directions for future research.
美国数十年来一直存在不良出生结局方面明显的社会和种族差异，近期为解释这些差异所做的努力已超越产前因素，去探索孕前社会状况，这些状况可能通过生理过程失调影响围产期健康。然而，由于缺乏数据和理论，支持这种联系的现有证据仍然有限。为解决后者，本手稿生成了一组结构化的理论见解，进一步阐述了两种孕前社会状况——居住地和社会关系——与围产期健康之间的联系。这些见解如下：
必然涵盖女性从婴儿期到青年期所接触的所有社会环境；涵盖各种相关暴露因素，如有可能，应综合考虑；可能会加剧贫困在儿童期、青少年期或青年期对围产期健康造成的影响。社会关系：涵盖从早年到成年期的人际关系，并延伸至代际关联；常常涉及（或引发）个人生活中的重大变化，应着重从变化发生时的发育阶段进行审视；必然包括缺乏社会融合，即社会孤立。我们还确定了将这些孕前社会状况与围产期健康联系起来的潜在生物学和社会结构机制，并通过确定未来研究的有前景方向得出结论。
