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不良出生结局作为法国新生儿人群中胎儿生长条件不良的指标——按邻里剥夺程度分层分析。

Adverse Birth Outcomes as Indicators of Poor Fetal Growth Conditions in a French Newborn Population-A Stratified Analysis by Neighborhood Deprivation Level.

机构信息

LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 6700 Strasbourg, France.

EHESP School of Public Health, Rennes, 35043 Cedex, France.

出版信息

Int J Environ Res Public Health. 2019 Oct 23;16(21):4069. doi: 10.3390/ijerph16214069.

Abstract

: Adverse birth outcomes are related to unfavorable fetal growth conditions. A latent variable, named Favorable Fetal Growth Condition (FFGC), has been defined by Bollen et al., in 2013; he showed that this FFGC latent variable mediates the effects of maternal characteristics on several birth outcomes. : The objectives of the present study were to replicate Bollen's approach in a population of newborns in Paris and to investigate the potential differential effect of the FFGC latent variable according to the neighborhood socioeconomic level. : Newborn health data were available from the first birth certificate registered by the Maternal and Child Care department of the City of Paris. All newborns (2008-2011) were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level. Several mothers' characteristics were collected from the birth certificates: age, parity, education and occupational status and the occupational status of the father. Three birth outcomes were considered: birth weight (BW), birth length (BL) and gestational age (GA). : Using a series of structural equation models, we confirm that the undirected model (that includes the FFGC latent variable) provided a better fit for the data compared with the model where parental characteristics directly affected BW, BL, and/or GA. However, the strength, the direction and statistical significance of the associations between the exogenous variables and the FFGC were different according to the neighborhood deprivation level. Future research should be designed to assess the how robust the FFGC latent variable is across populations and should take into account neighborhood characteristics to identify the most vulnerable group and create better design prevention policies.

摘要

不良出生结局与胎儿生长不良有关。2013 年,Bollen 等人定义了一个潜在变量,称为有利胎儿生长条件(FFGC);他表明,该 FFGC 潜在变量中介了母体特征对多种出生结局的影响。

本研究的目的是在巴黎新生儿人群中复制 Bollen 的方法,并根据邻里社会经济水平调查 FFGC 潜在变量的潜在差异效应。

新生儿健康数据来自巴黎母婴保健部门登记的第一份出生证明。所有新生儿(2008-2011 年)均按母亲居住的普查区进行地理编码。每个普查区都被分配了一个社会经济剥夺水平。从出生证明中收集了几个母亲的特征:年龄、胎次、教育和职业状况以及父亲的职业状况。考虑了三种出生结局:出生体重(BW)、出生长度(BL)和胎龄(GA)。

使用一系列结构方程模型,我们证实,与父母特征直接影响 BW、BL 和/或 GA 的模型相比,无向模型(包含 FFGC 潜在变量)更适合数据。然而,根据邻里剥夺程度的不同,外生变量与 FFGC 之间的关联的强度、方向和统计学意义也不同。未来的研究应设计来评估 FFGC 潜在变量在不同人群中的稳健性,并应考虑邻里特征,以确定最脆弱的群体并制定更好的预防政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7438/6861961/9e299b5c8b56/ijerph-16-04069-g001.jpg

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