孕期生活事件暴露可能增加子代低出生体重发生风险，而母亲高社会支持水平可能对此具有缓冲作用

The effect of exposure to prenatal life events and social support levels on low birth weight in offspring: a prospective cohort study

孕期生活事件暴露及社会支持水平对子代低出生体重的影响：前瞻性队列研究

Authors: Zhai Lulu, Tan Jianqin, Fang Chunchun, Wang Luning, Shen Lijun, Ding Qianqian, Wang Fang, Tao Fangbiao.

Source: Zhonghua Yu Fang Yi Xue Za Zhi.

DOI: 10.3760/cma.j.cn112150-20240603-00445

Abstract

Objective: To analyze the effects of exposure to life events and social support levels during different stages of pregnancy on low birth weight in offspring.

Methods: From 2021 to 2023, pregnant women in early pregnancy who were registered with health cards in Linping District, Hangzhou City, were recruited and followed up. The Life Events Scale for Pregnant Women (LESPW) and Social Support Rating Scale (SSRS) were used to evaluate the exposure to life events and social support levels of pregnant women in early, middle and late pregnancy, respectively. A generalized linear model was used to analyze the impact and critical period of exposure to prenatal life events and social support levels on the risk of low birth weight in offspring.

Results: A total of 3 663 pregnant women with ages M (Q1, Q3) of 29.18 (26.59, 32.21) years were included in this study.116 cases (3.17%) of infants with low birth weight were delivered. Generalized linear model analysis showed no correlation between the level of social support in early, middle and late pregnancy and low birth weight in offspring (all P＞0.05). The risk of low birth weight in offspring of pregnant women with high exposure to early pregnancy life events was 1.78 times higher than that of the low exposure group (RR=1.78, 95%CI: 1.13-2.73, P=0.010), and there was no association in the middle and late stages of pregnancy (both P＞0.05). Pregnant women with high exposure to early life events.and low levels of social support had a 2.08-fold higher risk of low birth weight in their offspring compared to the low exposure group (RR=2.08, 95%CI: 1.17-6.78, P=0.010), while this situation was not associated with high social support stratification.

Conclusion: Exposure to life events during pregnancy has an early window effect on birth weight. Increased exposure to life events during early pregnancy is associated with a higher risk of low birth weight in offspring. This association is more pronounced in pregnant women with low social support.

Key words: Pregnancy；Life change events；Social support；Birth weight； Cohort studies

摘要

目的：分析妊娠不同时期生活事件暴露及社会支持水平对子代低出生体重的影响。

方法：于 2021—2023年招募杭州市临平区孕早期建卡孕妇并对其进行随访，采用生活事件量表、社会支持量表分别于孕早、中、晚期评估孕妇生活事件暴露及社会支持水平。使用广义线性模型分析孕期生活事件暴露及社会支持水平对子代低出生体重发生风险的影响及作用关键期。

结果：本研究共纳入3 663名孕妇，年龄M（Q1，Q3）为29.18（26.59，32.21）岁，分娩低出生体重儿116例（3.17%）。广义线性模型分析显示，孕早、中、晚期社会支持水平与子代低出生体重无关联（均P＞0.05）；孕早期生活事件高暴露孕妇子代发生低出生体重的风险是低暴露组的1.78 倍（RR=1.78，95%CI：1.13~2.73，P=0.010），孕中、晚期无关联（均P＞0.05）；孕早期生活事件高暴露孕妇同时处于低社会支持水平，其子代发生低出生体重的风险是低暴露组的2.08倍（RR=2.08，95%CI：1.17~6.78，P=0.010），而这种情况在高社会支持分层中无关联。

结论：孕期生活事件暴露对出生体重影响具有早期窗口效应，孕早期生活事件暴露的水平越高，其子代低出生体重发生风险越高，且这种关联在低社会支持的孕妇中表现更明显。

关键词：妊娠；生活事件；社会支持；出生体重；队列研究