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Shared unmeasured characteristics among siblings confound the association of Apgar score with stress resilience in adolescence
Örebro University, School of Health Sciences. (Clinical Epidemiology and Biostatistics)
Örebro University, School of Medical Sciences. Department of Public Health Sciences, Stockholm University, Stockholm, Sweden. (Clinical Epidemiology and Biostatistics)ORCID iD: 0000-0002-2088-0530
Örebro University, School of Health Sciences.ORCID iD: 0000-0002-5996-2584
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-3649-2639
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2019 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIM: We investigated the association between low Apgar score, other perinatal characteristics and low stress resilience in adolescence. A within-siblings analysis was used to tackle unmeasured shared familial confounding.

METHODS: We used a national cohort of 527,763 males born in Sweden between 1973 and 1992 who undertook military conscription assessments at mean age 18 years (17-20). Conscription examinations included a measure of stress resilience. Information on Apgar score and other perinatal characteristics was obtained through linkage with the Medical Birth Register. Analyses were conducted using ordinary least squares and fixed-effects linear regression models adjusted for potential confounding factors.

RESULTS: Infants with a prolonged low Apgar score at five minutes had an increased risk of low stress resilience in adolescence compared to those with highest scores at one minute, with an adjusted coefficient and 95% confidence interval of -0.26 (-0.39, -0.13). The associations were no longer statistically significant when using within-siblings models. However, the associations with stress resilience and birthweight remained statistically significant in all analyses.

CONCLUSION: The association with low Apgar score seems to be explained by confounding due to shared childhood circumstances among siblings from the same family, while low birthweight is independently associated with low stress resilience.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019.
Keywords [en]
Apgar score, adolescence, low birth weight, psychological stress, resilience
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-74554DOI: 10.1111/apa.14881PubMedID: 31140196OAI: oai:DiVA.org:oru-74554DiVA, id: diva2:1320590
Available from: 2019-06-05 Created: 2019-06-05 Last updated: 2019-06-05Bibliographically approved

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Bergh, CeciliaHiyoshi, AyakoEriksson, MatsFall, KatjaMontgomery, Scott

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