Bøhler E, Bergström S
Department of International Health, University of Oslo, Norway.
J Biosoc Sci. 1995 Oct;27(4):431-42. doi: 10.1017/s002193200002304x.
A prospective study of 113 children in rural Bhutan registered their morbidity and weight and their mothers' subsequent pregnancies, monthly for 32 months during the children's first 3 years of life. Children whose mothers had a subsequent birth interval of 18-30 months had an incidence of diarrhoea during the subsequent pregnancy 50% higher than their matched cohort whose mothers did not become pregnant (p = 0.02). The relative risk for diarrhoea calculated from pooled child months was 1.51. Children whose mothers became pregnant also tended to have a higher incidence of skin infections. Children, whose mothers were pregnant when they terminated breastfeeding, experienced an increased incidence of diarrhoea around weaning (p = 0.01). Children weaned at the same age from non-pregnant mothers did not show increased morbidity. This study, for the first time, relates observations of children's morbidity directly in time to the occurrence of the mother's subsequent pregnancy, and provides evidence of a causal relationship between a moderately short subsequent birth interval and a concurrent increase in morbidity for the study child.
一项针对不丹农村地区113名儿童的前瞻性研究，在这些儿童生命的头3年里，每月记录他们的发病率、体重以及其母亲随后的怀孕情况，为期32个月。母亲随后生育间隔为18至30个月的儿童，在其母亲随后怀孕期间患腹泻的发生率比其母亲未怀孕的匹配队列高50%（p = 0.02）。根据汇总的儿童月数计算出的腹泻相对风险为1.51。母亲怀孕的儿童患皮肤感染的发生率也往往较高。母亲在终止母乳喂养时怀孕的儿童，在断奶前后患腹泻的发生率增加（p = 0.01）。在相同年龄从未怀孕母亲处断奶的儿童未出现发病率增加的情况。这项研究首次将对儿童发病率的观察与母亲随后怀孕的发生直接在时间上联系起来，并提供了证据表明适度较短的随后生育间隔与研究儿童发病率同时增加之间存在因果关系。
