Which modifiable prenatal factors mediate the relation between socio‐economic position and a child's weight and length at birth?
2019
Ballon, Morgane | Botton, Jérémie | Forhan, Anne | de Lauzon-Guillain, B | Lauzon‐guillain, Blandine | Melchior, Maria | El Khoury, Fabienne | Nakamura, Aurelie | Charles, Marie Aline | Lioret, Sandrine | Heude, Barbara | Equipe 6 : ORCHAD - Origines précoces de la santé du développement de l'enfant (CRESS - U1153) ; Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)) ; Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM) | Faculté de Pharmacie ; Université Paris-Sud - Paris 11 (UP11) | Institut National de la Recherche Agronomique (INRA) | Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP) ; Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU) | National Institute for Research in Public Health (IRESP TGIR Cohorte Sante 2008 Program); National Agency for Research (ANR nonthematic program)French National Research Agency (ANR); French Speaking Association for the Study of Diabetes and Metabolism (Alfediam); Mutuelle Generale de l'Education Nationale; Nestle; French National Institute for Health Education (INPES)Institut National de la Sante et de la Recherche Medicale (Inserm); ParisSud University; French Agency for Environment Security (AFFSET)French National Research Agency (ANR); French Ministry of Health Perinatal Program; INSERM Nutrition Research ProgramInstitut National de la Sante et de la Recherche Medicale (Inserm); Institut Federatif de Recherche and Cohort Program; French Ministry of ResearchMinistry of Research, France; Fondation pour la Recherche MedicaleFondation pour la Recherche Medicale
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Show more [+] Less [-]English. Although several studies have shown a positive association between socio-economic position and size at birth, not enough is known about the modifiable factors that may be involved. We aimed to investigate whether maternal prepregnancy body mass index (BMI), smoking, diet, and depression during pregnancy mediate the positive association between maternal education and birth size. Weight and length z-scores specific for gestational age and sex were calculated for 1,500 children from the EDEN mother-child cohort. A mediation analysis of the associations between maternal education and birth size was conducted with a counterfactual method, adjusted for recruitment centre, parity, maternal height, and age. In the comparison of children of mothers with low versus intermediate education levels, maternal smoking during pregnancy explained 52% of the total effect of education on birth weight. Similar findings were observed with birth length z-score (37%). The comparison of children of mothers with high versus intermediate education levels yielded a non-significant total effect, which masked opposite mediating effects by maternal BMI and smoking during pregnancy on both birth weight and length. Prepregnancy BMI and maternal smoking during pregnancy mediate the positive association between maternal education and birth weight and length z-scores. These mediators, however, act in opposite directions, thereby masking the extent to which healthy prenatal growth is socially differentiated.
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