Department of Health Services, University of Washington School of Public Health, Seattle, Washington, United States of America.
Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, United States of America.
PLoS One. 2020 May 29;15(5):e0233734. doi: 10.1371/journal.pone.0233734. eCollection 2020.
Several studies have suggested that record high unemployment during the Great Recession was associated with deleterious changes in diet and weight-related health. However, studies have yet to explore whether the Great Recession was also associated with obesity-related health in utero.
We investigated whether increasing county-level unemployment was associated with large-for-gestational age (LGA) births, using repeated cross-sectional data from California birth records between 2008 and 2011 (n = 1,715,052). LGA was defined as >90th percentile, using the Oken reference. We use the annual 1-year lagged value for county-level unemployment (2007-2010) and limit our analyses to singleton, term births. Linear probability models, with county and year fixed-effects were used to examine the unemployment-LGA association. All models control for county-level foreclosure rates, child gender, and maternal age, parity, education, and race/ethnicity.
An increase in county-level unemployment was not statistically significantly associated with the prevalence of LGA (percentage point [PP]: 0.12; 95% CI: -0.02, 0.25). But, over the period of observation, for every one standard deviation increase in unemployment, LGA prevalence increased by 5% and p = 0.08.
These results cautiously suggest some deleterious effects of the Great Recession on obesity-related health in utero.
多项研究表明，大衰退期间创纪录的高失业率与饮食和与体重相关的健康的有害变化有关。然而，研究尚未探讨大衰退是否也与胎儿期肥胖相关的健康有关。
我们使用加利福尼亚州 2008 年至 2011 年的出生记录中的重复横断面数据，调查了县一级失业率的上升是否与巨大儿出生（LGA）有关（n=1,715,052）。LGA 的定义为>第 90 百分位数，使用 Oken 参考值。我们使用县一级失业率的年度 1 年滞后值（2007-2010），并将分析仅限于单胎足月分娩。使用线性概率模型，包括县和年份固定效应，检验失业率与 LGA 的关联。所有模型均控制了县一级的止赎率、儿童性别以及产妇年龄、生育次数、教育程度和种族/民族。
县一级失业率的上升与 LGA 的流行率没有统计学上的显著关联（百分点 [PP]：0.12；95%置信区间：-0.02，0.25）。但是，在观察期间，失业率每增加一个标准差，LGA 的流行率就增加 5%，p=0.08。
这些结果谨慎地表明，大衰退对胎儿期肥胖相关健康有一些有害影响。
