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孕期头三个月的居住地变化与不良出生结局。

Residence change during the first trimester of pregnancy and adverse birth outcomes.

机构信息

Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA

Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA.

出版信息

J Epidemiol Community Health. 2019 Oct;73(10):913-919. doi: 10.1136/jech-2018-211937. Epub 2019 Jul 30.

Abstract

BACKGROUND

There are few published studies evaluating the impact of perinatal residence change on infant outcomes and whether these associations differ by socioeconomic status.

METHODS

We conducted a population-based cohort study using Washington State birth certificate data from 2007 to 2014 to assess whether women who moved during the first trimester of pregnancy (n=28 011) had a higher risk of low birth weight, preterm birth and small for gestational age than women who did not move during the first trimester (n=112 367). 'Non-first-trimester movers' were frequency matched 4:1 to movers by year. We used generalised linear models to calculate risk ratios and risk differences adjusted for maternal age, race, marital status, parity, education, smoking, income and insurance payer for the birth. We also stratified analyses by variables related to socioeconomic status to see whether associations differed across socioeconomic strata.

RESULTS

Moving in the first trimester was associated with an increased risk of low birth weight (6.4% vs 4.5%, adjusted risk ratio 1.37 (95% CI 1.29 to 1.45)) and preterm birth (9.1% vs 6.4%, adjusted risk ratio 1.42 (95% CI 1.36 to 1.49)) and a slight increased risk of small for gestational age (9.8% vs 8.7%, adjusted risk ratio 1.09 (95% CI 1.00 to 1.09)). Residence change was associated with low birth weight and preterm birth in all socioeconomic strata.

CONCLUSION

Moving during the first trimester of pregnancy may be a risk factor for adverse birth outcomes in US women. Healthcare providers may want to consider screening for plans to move and offering support.

摘要

背景

很少有研究评估围产期居住地变化对婴儿结局的影响,以及这些关联是否因社会经济地位而异。

方法

我们使用华盛顿州 2007 年至 2014 年的出生证明数据进行了一项基于人群的队列研究,以评估在妊娠早期(n=28011)搬家的女性与未在妊娠早期搬家的女性(n=112367)相比,低出生体重、早产和小于胎龄儿的风险是否更高。“非妊娠早期搬家者”按年与搬家者以 4:1 的比例进行频数匹配。我们使用广义线性模型计算了调整了母亲年龄、种族、婚姻状况、产次、教育程度、吸烟、收入和保险支付者后,出生时的风险比和风险差异。我们还按与社会经济地位相关的变量进行了分层分析,以了解关联是否在社会经济阶层之间存在差异。

结果

妊娠早期搬家与低出生体重(6.4%比 4.5%,调整风险比 1.37(95%CI 1.29 至 1.45))和早产(9.1%比 6.4%,调整风险比 1.42(95%CI 1.36 至 1.49))的风险增加有关,并且小于胎龄儿的风险略有增加(9.8%比 8.7%,调整风险比 1.09(95%CI 1.00 至 1.09))。在所有社会经济阶层中,居住地变化与低出生体重和早产有关。

结论

妊娠早期搬家可能是美国女性不良出生结局的一个风险因素。医疗保健提供者可能需要考虑筛查搬家计划并提供支持。

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