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首页> 外文学位 >Intergenerational Change in Maternal Education and Risk of Preterm Birth and Small-For-Gestational Age in White Non-Hispanic, Black Non-Hispanic and Hispanic Women in New Jersey
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Intergenerational Change in Maternal Education and Risk of Preterm Birth and Small-For-Gestational Age in White Non-Hispanic, Black Non-Hispanic and Hispanic Women in New Jersey

机译：新泽西州的白人非西班牙裔，黑人非西班牙裔和西班牙裔女性的孕产妇教育代际变化和早产风险及小胎龄风险

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摘要

Aims.;In this thesis we examine the effect of grandmother's education on the risk of preterm birth (PTB) and small-for-gestational (SGA) in her grandchildren after accounting for mother's education.;Background.;Maternal lifelong socioeconomic status (SES) is believed to affect reproductive health. There are many studies that have shown strong association of mother's current SES with adverse birth outcomes. However, few studies have investigated associations with mother's childhood SES or grandparents' education. In U.S. blacks, previous data suggest that improvement in SES from childhood to adulthood is associated with improved social and mental health outcomes, but perinatal outcomes have rarely been assessed.;Methods.;We created a transgenerational dataset to examine the effect of grandmother's education, a dimension of SES, on risk of PTB and SGA in grandchildren. Using Link King Software we matched female infants listed on NJ birth certificates in 1979-1983 to mothers listed on NJ birth certificates for the years 1999-2011. Thus grandmothers were the women delivering in 1979-1983, and mothers were those born to the grandmothers who in turn delivered grandchildren in 1999-2011. We performed descriptive tabulations and multivariate logistic regression to create risk estimates using Statistical Analysis System (SAS) software.;Results.;In total we linked 107,347 grandmother and mother pairs. After exclusions (multiple births, gestational age of less than 20 weeks and greater than 47 weeks and other races) there were 99,463 pairs available for analysis. Overall, maternal education was associated inversely with PTB and SGA births in each of the largest demographic groups (non-Hispanic whites and blacks and Hispanics). There was a substantial inter-generational increase in education between grandmothers and mothers in each group, but it was most striking in Hispanics. SGA was more common in 1979-83 births than in 1999-2011. After adjusting for potential confounders, grandmother's education was as strongly associated with PTB of grandchildren as was mother's education. SGA in grandchildren was more common among low-education mothers, but grandmother's education had little effect. Although the overall SGA rates were higher in blacks and Hispanics as compared to whites, the effect of lower maternal education on risk of SGA was strongest in whites, and after adjusting for confounders it lost significance in blacks and Hispanics especially in the 1999-2011 births. Father's education was inversely related to PTB and SGA in all three ethnic groups and across both generations.;Conclusions.;In summary, we found that maternal education was an important predictor of PTB and SGA both in 1979-82 and in 1999-2011. Grandmother's education was as strong a predictor of PTB in grandchildren as mothers. However, grandmother's education was not strongly related to SGA in the grandchildren. Our results suggest that mother's childhood and preconception socioeconomic environment, including the educational level of her childhood household, are independent predictors for delivering preterm, but have less effect on intra-uterine growth.
机译：目的；本论文探讨了在考虑了母亲的教育后，祖母的教育对其孙子的早产风险（PTB）和小胎教（SGA）的影响。；背景；孕产妇的终身社会经济地位（SES） ）被认为会影响生殖健康。许多研究表明母亲当前的SES与不良的出生结局密切相关。但是，很少有研究调查与母亲的童年SES或祖父母的教育有关。在美国黑人中，以前的数据表明，从儿童期到成年期SES的改善与改善的社会和心理健康状况相关，但很少评估围产期的状况。方法：我们创建了一个跨代数据集来检查祖母的教育效果， SES的一个方面，关于孙辈中PTB和SGA的风险。使用Link King软件，我们将1979-1983年在新泽西州出生证明中列出的女婴与1999-2011年在新泽西州出生证明中列出的母亲相匹配。因此，祖母是1979-1983年分娩的妇女，母亲是祖母所生的，后者又在1999-2011年分娩了孙子。我们使用统计分析系统（SAS）软件进行了描述性制表和多元逻辑回归，以创建风险估计。结果。总共，我们对107,347对祖母进行了链接。排除后（多胎，小于20周且大于47周的胎龄以及其他种族），有99,463对可用于分析。总体而言，在每个最大的人口群体（非西班牙裔的白人，黑人和西班牙裔）中，孕产妇教育与PTB和SGA的出生成反比。在每个组中，祖母和母亲之间的世代教育都有显着提高，但在西班牙裔中尤为明显。 1979-83年出生的SGA比1999-2011年更为普遍。在对潜在的混杂因素进行调整之后，祖母的教育与孙子的PTB紧密相关，就像母亲的教育一样。在低学历的母亲中，孙子的SGA更为常见，但祖母的教育影响不大。尽管黑人和西班牙裔美国人的总体SGA率比白人高，但较低的孕产妇教育对SGA风险的影响在白人中最为明显，在对混杂因素进行调整后，其在黑人和西班牙裔美国人中的意义特别是在1999-2011年出生。父亲的教育在这三个民族以及两代人中都与PTB和SGA呈负相关。结论：总之，我们发现，在1979-82年和1999-2011年，孕产妇教育是PTB和SGA的重要预测指标。祖母的教育与孙女一样强烈地预测了子孙中的PTB。但是，祖母的教育与孙辈中的SGA无关。我们的结果表明，母亲的童年和受孕前的社会经济环境，包括她的童年家庭的受教育程度，是提供早产的独立预测因子，但对子宫内生长的影响较小。

著录项

  • 作者

    Jain, Neetu Jitendra.;

  • 作者单位

    Rutgers The State University of New Jersey - New Brunswick.;

  • 授予单位 Rutgers The State University of New Jersey - New Brunswick.;
  • 学科 Public health.
  • 学位 Ph.D.
  • 年度 2018
  • 页码 105 p.
  • 总页数 105
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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