BACKGROUND & AIMS:
:We examined whether maternal educational level as an indicator of socioeconomic status is associated with gestational hypertension. We also examined the extent to which the effect of education is mediated by maternal substance use (that is smoking, alcohol consumption and illegal drug use), pre-existing diabetes, anthropometrics (that is height and body mass index (BMI)) and blood pressure at enrollment. This was studied in 3262 Dutch pregnant women participating in the Generation R Study, a population-based cohort study. Level of maternal education was established by questionnaire at enrollment, and categorized into high, mid-high, mid-low and low. Diagnosis of gestational hypertension was retrieved from medical records using standard criteria. Odds ratios (OR) of gestational hypertension for educational levels were calculated, adjusted for potential confounders and additionally adjusted for potential mediators. Adjusted for age and gravidity, women with mid-low (OR: 1.52; 95% CI: 1.02, 2.27) and low education (OR: 1.30; 95% CI: 0.80, 2.12) had a higher risk of gestational hypertension than women with high education. Additional adjustment for substance use, pre-existing diabetes, anthropometrics and blood pressure at enrollment attenuated these ORs to 1.09 (95% CI: 0.70, 1.69) and 0.89 (95% CI: 0.50, 1.58), respectively. These attenuations were largely due to the effects of BMI and blood pressure at enrollment. Women with relatively low educational levels have a higher risk of gestational hypertension, which is largely due to higher BMI and blood pressure levels from early pregnancy. The higher risk of gestational hypertension in these women is probably caused by pre-existing hypertensive tendencies that manifested themselves during pregnancy.
背景与目标:
:我们研究了孕产妇受教育程度作为社会经济地位的指标是否与妊娠高血压相关。我们还研究了母体物质使用(即吸烟,饮酒和非法药物使用),既往糖尿病,人体测量学(即身高和体重指数(BMI))和血液对教育效果的影响程度入学压力。这项研究是在3262名荷兰孕妇中进行的,该研究参加了基于人群的队列研究“ Generation R Study”。入学时通过问卷调查确定孕产妇教育水平,并将其分为高,中高,中低和低。使用标准标准从病历中检索出妊娠高血压的诊断。计算了教育程度的妊娠高血压的赔率(OR),针对潜在的混杂因素进行了调整,并针对潜在的调解人进行了调整。经过年龄和妊娠度调整后,中低(OR:1.52; 95%CI:1.02、2.27)和低学历(OR:1.30; 95%CI:0.80、2.12)的妇女比患有HLA的妇女发生妊娠高血压的风险更高高等教育。对药物使用,既往存在的糖尿病,人体测量学和入学时血压进行的其他调整分别将这些OR衰减至1.09(95%CI:0.70,1.69)和0.89(95%CI:0.50,1.58)。这些衰减主要归因于入学时的BMI和血压的影响。受教育程度相对较低的妇女发生妊娠高血压的风险较高,这在很大程度上是由于早孕期的BMI和血压水平较高。这些妇女的妊娠高血压风险较高,可能是由于怀孕期间已存在的高血压倾向所致。