This multilevel study of spatial variability in, and determinants of, birthweight was conducted using individual and ecological data in a geographically defined prospective birth cohort for 1986 in northern Finland. The study area comprises three large areas defined by latitudeNorthern Lapland (NL), Southern Lapland (SL) and Oulu province (OP), comprising 74 localities with a total study population of 9216 singleton births. The mean birthweight was 3482 g for NL, 3537 g for SL and 3587 g for OP (NL vs. OP and SL vs.

OP:P < 0.05). The crude rate for stillbirths was highest in NL. The women in the northernmost area were socially less privileged and the localities less prosperous compared with those in the southernmost area. Significant spatial clustering of mean birthweights was found (P = 0.0016), with highest birthweight in the south-western part of the study area. A variable expressing the wealth of each locality, the financial capacity category (FCC), had its lowest mean value in NL, with a range of one to six for the localities studied here. A multilevel multiple regression model showed that, after allowing for sex, gestational age, mother's age, height and hypertensive disorders, parity, body mass index, previous low birthweight child and smoking as individual determinants of birthweight, part of the residual variation could be explained by the locality wealth parameter. Using the multilevel model, the differences in mean birthweight across the three latitude areas persisted but were reduced (difference OP vs. NL reduced from 105 g to 86.5 g). The relationship between birthweight and FCC was inverse U-shaped with the highest mean birthweight estimated for localities occurring in the middle of the range (FCC = 3). The wealthiest urban localities (FCC = 6) and the most deprived localities (FCC = 1) both had a predicted birthweight about 60 g below the maximum at FCC = 3, if all other factors were held constant. This result, taken together with the spatial clustering of birthweights, suggests that there may be important social and environmental determinants of birthweight that have yet to be identified.

译文

这项关于出生体重的空间变异性和决定因素的多层次研究是在1986年芬兰北部一个地理上定义的预期出生队列中使用个体和生态数据进行的。研究区域由北拉普兰(NL),南拉普兰(SL)和奥卢省(OP)定义的三个大区域组成,包括74个地区,总研究人口为9216单胎出生。 NL的平均出生体重为3482 g,SL的平均出生体重为3537 g,OP的平均出生体重为3587 g(NL vs. OP和SL vs.

OP :P <0.05)。死产的粗率在荷兰最高。与最南端的地区相比,最北端的地区妇女在社会上的特权较低,而当地的繁荣程度也较低。发现平均出生体重的显着空间聚类(P = 0.0016),在研究区域的西南部具有最高的出生体重。表示每个地方的财富的变量,即财务能力类别(FCC),其平均值在NL中最低,此处研究的地方的范围为1到6。多级多元回归模型显示,在考虑性别,胎龄,母亲的年龄,身高和高血压疾病,均等,体重指数,以前的低出生体重儿童和吸烟作为出生体重的单独决定因素之后,可以解释部分剩余变异由当地的财富参数决定。使用多级模型,三个纬度地区的平均出生体重差异持续存在,但有所减少(OP与NL的差异从105 g减少到86.5 g)。出生体重与FCC之间的关系呈倒U形,在该区域的中间(FCC = 3),估计的平均出生体重最高。如果所有其他因素保持不变,则最富裕的城市地区(FCC = 6)和最贫困的地区(FCC = 1)的预期出生体重都比FCC = 3时的最大值低约60 g。该结果与出生体重的空间聚类一起表明,可能还有一些重要的社会和环境决定因素尚未确定。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录