Obstetrician-Assessed Maternal Health at Pregnancy Predicts Offspring Future Health 英文参考文献.docVIP

Obstetrician-AssessedMaternalHealthatPregnancy PredictsOffspringFutureHealth DebbieALawlor1*,SusanMorton2,G.DavidBatty3,4,SallyMacintyre3,HeatherClark5,GeorgeDaveySmith1 1TheMRCCentreforCausalAnalysesinTranslationalEpidemiology,DepartmentofSocialMedicine,UniversityofBristol,UnitedKingdom,2School ofPopulationHealthandLigginsInstitute,UniversityofAuckland,Auckland,NewZealand,3MRCSocialandPublicHealthSciencesUnit,Universityof Glasgow,Glasgow,Scotland,4DepartmentofPsychology,UniversityofEdinburgh,Edinburgh,Scotland,5TheDugaldBairdCentreforResearchon Women’sHealth,UniversityofAberdeen,Scotland Background.Weaimedtoexaminetheassociationbetweenobstetricianassessmentofmaternalphysicalhealthatthetimeof pregnancyandoffspringcardiovasculardiseaserisk.MethodsandPrincipalFindings.Weexaminedthisassociationinabirth cohort of 11,106 individuals, with 245,000 person years of follow-up. We were concerned that any associations might be explained by residual confounding, particularly by family socioeconomic position. In order to explore this we used multivariableregressionmodelsinwhichweadjustedforarangeofindicatorsofsocioeconomicpositionandweexploredthe specificity of the association. Specificity of association was explored by examining associations with other health related outcomes. Maternal physical health was associated with cardiovascular disease: adjusted (socioeconomic position, complications of pregnancy, birthweight and childhood growth at mean age 5) hazard ratio comparing those described as havingpoororverypoorhealthatthetimeofpregnancytothosewithgoodorverygoodhealthwas1.55(95%CI:1.05,2.28) forcoronaryheartdisease,1.91(95%CI:0.99,3.67)forstrokeand1.57(95%CI:1.13,2.18)foreithercoronaryheartdiseaseor stroke.However,thisassociationwasnotspecific.Therewerestrongassociationsforotheroutcomesthatareknowntobe related to socioeconomic position (3.61 (95%CI: 1.04, 12.55) for lung cancer and 1.28 (95%CI:1.03, 1.58) for unintentional injury),butnotforbreastcancer(1.10(95%CI:0.48,2.5