生命的前1000天对儿童的健康和发展至关重要。这一时期的生长障碍与儿童发病率增加有关,死亡率,和长期后果。营养不良是主要原因,在生命的前1000天内解决这个问题至关重要。产妇教育一直被认为是儿童营养不良的重要预测因素,但其具体影响尚待确定。这项研究提供了系统的回顾和荟萃分析,调查了高与低母亲教育水平对从出生到两岁儿童成长的影响,使用基于人群的队列研究。
■包括PubMed、Scopus,EMBASE,WebofScience,ERIC,和GoogleScholar从1990年1月到2024年1月使用适当的搜索词进行搜索。我们纳入了以人群为基础的2岁及以下健康儿童及其母亲的队列研究,对产妇教育水平进行分类。使用各种指标评估儿童生长和营养结果。两名评审员独立进行数据提取并评估研究质量。纽卡斯尔渥太华量表用于质量评估。随机效应模型用于荟萃分析,异质性使用CochraneQ和I2统计量进行评估。进行亚组和敏感性分析,并评估发表偏倚。
■文献检索到14295种,在对639份报告进行全文筛选后,包括35项研究,涵盖八个结果:体重年龄z得分(WAZ),身高年龄z评分(HAZ),BMI为年龄z得分(BMIZ),超重,体重不足,发育迟缓,浪费,和快速的体重增加。在中等收入国家,母亲受教育程度较高与儿童WAZ(MD0.398,95%CI0.301-0.496)和HAZ(MD0.388,95%CI0.102-0.673)升高显著相关.同样,在对低教育人口的研究中,较高的产妇教育水平与WAZ(MD0.186,95%CI0.078-0.294)和HAZ(0.200,95%CI0.036-0.365)的增加显著相关.然而,在高收入和受过高等教育的人群中,这种联系要么不存在,要么逆转。在高收入国家,母亲受教育程度较高与BMI-Z无显著降低相关(MD-0.028,95%CI-0.061~0.006).值得注意的是,这种负相关在低教育人群中具有统计学意义(MD-0.045,95%CI-0.079~-0.011),但在高教育人群中没有统计学意义(MD0.003,95%CI-0.093~0.098).
产妇教育与儿童成长的关系因国家/地区的收入和教育水平而异。需要进一步研究才能更好地理解这种关系。
■这项研究是由德黑兰医科大学(TUMS)资助的学生论文。
UNASSIGNED: The first 1000 days of life are critical for a child\'s health and development. Impaired growth during this period is linked to increased child morbidity, mortality, and long-term consequences. Undernutrition is the main cause, and addressing it within the first 1000 days of life is vital. Maternal education is consistently identified as a significant predictor of child undernutrition, but its specific impact remains to be determined. This study presents a systematic
review and meta-analysis investigating the influence of high versus low maternal education levels on child growth from birth to age two, using population-based cohort studies.
UNASSIGNED: Databases including PubMed, Scopus, EMBASE, Web of Science, ERIC, and Google Scholar were searched from January 1990 to January 2024 using appropriate search terms. We included population-based cohort studies of healthy children aged two years and under and their mothers, categorizing maternal education levels. Child growth and nutritional outcomes were assessed using various indicators. Two reviewers independently conducted data extraction and assessed study quality. The Newcastle Ottawa scale was utilized for quality assessment. Random-effects models were used for meta-analysis, and heterogeneity was assessed using the Cochrane Q and I2 statistic. Subgroup and sensitivity analyses were performed, and publication bias was evaluated.
UNASSIGNED: The literature search retrieved 14,295 titles, and after full-text screening of 639 reports, 35 studies were included, covering eight outcomes: weight for age z-score (WAZ), height for age z-score (HAZ), BMI for age z-scores (BMIZ), overweight, underweight, stunting, wasting, and rapid weight gain. In middle-income countries, higher maternal education is significantly associated with elevated WAZ (MD 0.398, 95% CI 0.301-0.496) and HAZ (MD 0.388, 95% CI 0.102-0.673) in children. Similarly, in studies with low-educated population, higher maternal education is significantly linked to increased WAZ (MD 0.186, 95% CI 0.078-0.294) and HAZ (0.200, 95% CI 0.036-0.365). However, in high-income and highly educated population, this association is either absent or reversed. In high-income countries, higher maternal education is associated with a non-significant lower BMI-Z (MD -0.028, 95% CI -0.061 to 0.006). Notably, this inverse association is statistically significant in low-educated populations (MD -0.045, 95% CI -0.079 to -0.011) but not in highly educated populations (MD 0.003, 95% CI -0.093 to 0.098).
UNASSIGNED: Maternal education\'s association with child growth varies based on country income and education levels. Further research is needed to understand this relationship better.
UNASSIGNED: This study was a student thesis supported financially by Tehran University of Medical Sciences (TUMS).