Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Pain/Stress Neurobiology Lab, Women& Child Health Research Institute, Stanford University School of Medicine, Stanford, CA, USA.
Acta Paediatr. 2019 Jul;108(7):1267-1277. doi: 10.1111/apa.14715. Epub 2019 Jan 25.
Early life adversity leads to enduring effects on physical and mental health, school performance and other outcomes. We sought to identify potentially modifiable factors associated with socioeconomic adversity in early life.
We enrolled 1503 pregnant women aged 16-40 years, without pregnancy complications or pre-existing conditions from Shelby County, Tennessee. Social, familial and economic variables were analysed using principal components (PCs) analyses to generate the Socioeconomic Adversity Index (SAI). This was replicated using the National Survey of Children's Health (NSCH). Health and social outcomes were compared across the quintile groups defined by SAI values at the county, state and national levels.
Significant differences occurred across the SAI Quintile-1 to Quintile-5 groups in marital status, household structure, annual income, education and health insurance. Significantly worse health and social outcomes occurred in the lower versus higher SAI quintiles, including maternal depression, parental incarceration, child's birthweight and potential for child abuse. Maternal age and race also differed significantly across the SAI quintiles.
Modifiable factors contributing to socioeconomic adversity in early life included marital status, household structure, annual income, education and health insurance. Those exposed to greater socioeconomic adversity as defined by SAI values had significantly worse maternal and child outcomes.
早期生活逆境会对身心健康、学业成绩和其他结果产生持久影响。我们试图确定与早期生活社会经济逆境相关的潜在可改变因素。
我们招募了来自田纳西州谢尔比县的 1503 名 16-40 岁、无妊娠并发症或既往疾病的孕妇。使用主成分（PC）分析对社会、家庭和经济变量进行分析，以生成社会经济逆境指数（SAI）。使用国家儿童健康调查（NSCH）对其进行了复制。根据县、州和国家各级的 SAI 值，比较健康和社会结果在 SAI 五分位数组之间的差异。
在婚姻状况、家庭结构、年收入、教育和医疗保险方面，SAI 五分位数 1 组到 5 组之间存在显著差异。较低的 SAI 五分位数组与较高的 SAI 五分位数组相比，健康和社会结果明显较差，包括产妇抑郁、父母监禁、孩子的出生体重和虐待儿童的可能性。母亲年龄和种族也在 SAI 五分位数组之间存在显著差异。
导致早期生活社会经济逆境的可改变因素包括婚姻状况、家庭结构、年收入、教育和医疗保险。那些暴露于 SAI 值定义的更大社会经济逆境中的人，其母婴结局明显更差。
