Petridou E, Trichopoulos D, Revinthi K, Tong D, Papathoma E
Department of Hygiene and Epidemiology, Athens University Medical School, Greece.
Child Care Health Dev. 1996 Jan;22(1):37-53.
Several factors are known to affect birthweight and their effects are variously mediated through gestational duration or through fetal growth conditional on this gestation. In order to quantify independent associations of birthweight conditional and unconditional on gestational age, all 2538 mothers of singleton babies delivered during 1993 in two Maternity Hospitals in Athens were interviewed and their obstetric records abstracted. Birthweight was modelled as outcome variable through multiple regression including 32 potentially predictive factors. The regression model was fitted with and without gestational age as an additional independent variable in order to apportion birthweight associations into those independent of, or mediated through, gestational length. The factors studied were found to be classifiable into the following categories: factors associated with birthweight mostly through increases in gestational duration, either positively (age at menarche, long menstrual cycles, parity 4 or higher), or negatively (single motherhood, maternal age, tobacco smoking); those associated with birthweight mostly through increase of birthweight conditional on gestational duration, either positively (male gender, short menstrual cycles, maternal pre-pregnancy weight, anaemia, oedema) or inversely (employment during pregnancy, stillbirth, primiparity, pregnancy induced hypertension, coffee drinking); and those associated with birthweight through apparently dual effects, either positively (maternal education) or inversely (perceived stress, bleeding during pregnancy). The other studied factors were not demonstrably related to birthweight in this data set. Identification and quantification of these relations is useful for understanding underlying physiological and pathophysiological processes and for increasing specificity in exploring the association of birthweight with adult onset diseases, like coronary heart disease or cancer.
已知有几个因素会影响出生体重，其影响通过妊娠期或在此妊娠期基础上的胎儿生长以多种方式介导。为了量化出生体重在孕周条件下和无条件下的独立关联，对1993年在雅典两家妇产医院分娩的所有2538名单胎婴儿的母亲进行了访谈，并提取了她们的产科记录。通过多元回归将出生体重作为结果变量进行建模，多元回归包括32个潜在预测因素。回归模型在有和没有孕周作为额外自变量的情况下进行拟合，以便将出生体重关联分为独立于孕周长度或通过孕周长度介导的关联。研究发现，所研究的因素可分为以下几类：主要通过妊娠期延长影响出生体重的因素，包括正向影响（初潮年龄、月经周期长、产次为4次或更高）或负向影响（单身母亲身份、母亲年龄、吸烟）；主要通过在妊娠期基础上增加出生体重影响出生体重的因素，包括正向影响（男性性别、月经周期短、母亲孕前体重、贫血、水肿）或反向影响（孕期就业、死产、初产、妊娠高血压、喝咖啡）；以及通过明显的双重影响影响出生体重的因素，包括正向影响（母亲教育程度）或反向影响（感知压力、孕期出血）。在该数据集中，其他研究因素与出生体重没有明显关联。识别和量化这些关系有助于理解潜在的生理和病理生理过程，并有助于在探索出生体重与成人发病疾病（如冠心病或癌症）的关联时提高特异性。
