Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort challenges and opportunities in antenatal care 英文参考文献.docVIP

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Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort challenges and opportunities in antenatal care 英文参考文献.doc

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Stressful life events, social health issues and low birthweight in an Australian population-based birth cohort challenges and opportunities in antenatal care 英文参考文献

Brownetal.BMCPublicHealth2011,11:196 /1471-2458/11/196 RESEARCH ARTICLE OpenAccess Stressfullifeevents,socialhealthissuesandlow birthweightinanAustralianpopulation-based birthcohort:challengesandopportunitiesin antenatalcare StephanieJBrown1,2*,JaneSYelland1,GeorginaASutherland1,PeterABaghurst3andJeffreySRobinson3 Abstract Background:Investmentinstrategiestopromote‘ahealthystarttolife’hasbeenidentifiedashavingthegreatest potentialtoreducehealthinequalitiesacrossthelifecourse.Theaimofthisstudywastoexaminesocial determinantsoflowbirthweightinanAustralianpopulation-basedbirthcohortandconsiderimplicationsfor healthpolicyandhealthcaresystems. Methods:Population-basedsurveydistributedbyhospitalsandhomebirthpractitionersto8000womensix monthsafterchildbirthintwostatesofAustralia.Participantswerewomenwhogavebirthtoaliveborninfantin VictoriaandSouthAustraliainSeptember/October2007.Mainoutcomemeasuresincludedstressfullifeeventsand socialhealthissues,perceiveddiscriminationinhealthcaresettings,infantbirthweight. Results:4,366/8468(52%)ofeligiblewomenreturnedcompletedsurveys.Two-thirds(2912/4352)reportedoneor morestressfullifeeventsorsocialhealthissuesduringpregnancy.Womenreportingthreeormoresocialhealth issues(18%,768/4352)weresignificantlymorelikelytohavealowbirthweightinfant(2500grams)after controllingforsmokingandothersocio-demographiccovariates(AdjOR=1.77,95%CI1.1-2.8).Mothersborn overseasinnon-Englishspeakingcountriesalsohadahigherriskofhavingalowbirthweightinfant(AdjOR= 1.85,95%CI1.2-2.9).Womenreportingthreeormorestressfullifeevents/socialhealthissuesweremorelikelyto attendantenatalcarelaterinpregnancy(OR=2.06,95%CI1.3-3.1),tohavefewerantenatalvisits(OR=2.17,95% CI1.4-3.4)andtoexperiencediscriminationinhealthcaresettings(OR=2.69,95%CI2.2-3.3). Conclusions:Thereisawindowofopportunityinantenatalcaretoimplementtargetedpreventiveinterventions addressingpotentiallymodifiableriskfactorsforpoormaternalandinfantoutcomes.Developingtheevidence baseandinfrastructurenecessaryinord