妊娠前三个月的居住地变化和不良分娩结局

Julia C. Bond, Amanda Mancenido, Divya M Patil, Seth Rowley, J. Goldberg, A. Littman
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引用次数: 6

摘要

背景很少有已发表的研究评估围产期居住改变对婴儿结局的影响,以及这些关联是否因社会经济地位而异。方法采用2007年至2014年华盛顿州出生证明数据进行了一项基于人群的队列研究,以评估在妊娠前三个月搬家的妇女(n= 28011)是否比在妊娠前三个月不搬家的妇女(n= 112367)有更高的低出生体重、早产和小胎龄风险。“非孕早期推动者”与推动者的频率按年份匹配为4:1。我们使用广义线性模型来计算风险比和风险差异,调整了产妇年龄、种族、婚姻状况、性别、教育程度、吸烟、收入和生育保险支付者。我们还通过与社会经济地位相关的变量进行分层分析,以了解社会经济阶层之间的关联是否存在差异。结果妊娠早期运动与低出生体重(6.4% vs 4.5%,调整风险比1.37 (95% CI 1.29 ~ 1.45))和早产(9.1% vs 6.4%,调整风险比1.42 (95% CI 1.36 ~ 1.49))和胎龄小的风险轻微增加(9.8% vs 8.7%,调整风险比1.09 (95% CI 1.00 ~ 1.09))相关。在所有社会经济阶层中,居住地变化与低出生体重和早产有关。结论妊娠前三个月搬家可能是美国妇女不良分娩结局的危险因素。医疗保健提供者可能会考虑为搬家计划进行筛查并提供支持。
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Residence change during the first trimester of pregnancy and adverse birth outcomes
Background There are few published studies evaluating the impact of perinatal residence change on infant outcomes and whether these associations differ by socioeconomic status. Methods We conducted a population-based cohort study using Washington State birth certificate data from 2007 to 2014 to assess whether women who moved during the first trimester of pregnancy (n=28 011) had a higher risk of low birth weight, preterm birth and small for gestational age than women who did not move during the first trimester (n=112 367). ‘Non-first-trimester movers’ were frequency matched 4:1 to movers by year. We used generalised linear models to calculate risk ratios and risk differences adjusted for maternal age, race, marital status, parity, education, smoking, income and insurance payer for the birth. We also stratified analyses by variables related to socioeconomic status to see whether associations differed across socioeconomic strata. Results Moving in the first trimester was associated with an increased risk of low birth weight (6.4% vs 4.5%, adjusted risk ratio 1.37 (95% CI 1.29 to 1.45)) and preterm birth (9.1% vs 6.4%, adjusted risk ratio 1.42 (95% CI 1.36 to 1.49)) and a slight increased risk of small for gestational age (9.8% vs 8.7%, adjusted risk ratio 1.09 (95% CI 1.00 to 1.09)). Residence change was associated with low birth weight and preterm birth in all socioeconomic strata. Conclusion Moving during the first trimester of pregnancy may be a risk factor for adverse birth outcomes in US women. Healthcare providers may want to consider screening for plans to move and offering support.
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