中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2008年
7期
661-667
,共7页
刘英惠%刘建蒙%刘伟宏%马蕊%叶荣伟%陈华%薛明君%成伶春%吴立民%潘玉娟%陈浩%任爱国%李松%李竹
劉英惠%劉建矇%劉偉宏%馬蕊%葉榮偉%陳華%薛明君%成伶春%吳立民%潘玉娟%陳浩%任愛國%李鬆%李竹
류영혜%류건몽%류위굉%마예%협영위%진화%설명군%성령춘%오립민%반옥연%진호%임애국%리송%리죽
新生儿窒息%体重指数%孕期
新生兒窒息%體重指數%孕期
신생인질식%체중지수%잉기
Neonatal asphyxia%Body mass index%Pregnancy
目的 了解孕前体重指数(BMI)、孕期体重增加与新生儿窒息发生危险的关系.方法 数据来自"中美预防出生缺陷和残疾合作项目"中嘉兴地区的围产保健监测数据库.研究对象为1995-2000年在嘉兴地区参加婚前/孕前体检且分娩单胎活产儿孕满20周的83 030名孕产妇.运用χ2检验或趋势χ2检验比较不同BMI组或其他特征人群新生儿窒息发病率的差别,利用多元logistic回归分析孕前BMI、孕期体重增加与新生儿窒息发生危险之间的关系.结果 新生儿窒息发病率为11.3%(95% CI:11.1%～11.6%).新生儿窒息发病率从BMI＜18.5 kg/m2组的11.0%(95% CI:10.5%～11.5%)逐渐升至BMI≥25.0 kg/m2组的12.9%(95% CI:11.6%～14.4%),自孕期体重增加＜0.3 kg/wk的12.4%(95% CI:11.9%～13.0%)逐渐降至≥0.5 kg/wk的10.6%(95% CI:10.1%～11.0%).孕前BMI≥25.0 kg/m2组的新生儿重度窒息发生率高于BMI更低组.在调整了地区、年龄、文化程度、职业、产次、产前检查次数、孕期高危因素、产时高危因素、孕周和出生体重后,以BMI＜18.5 kg/m2组为参照组,BMI为18.5～22.9 kg/m2、23.0～24.9 kg/m2和≥25.0 kg/m2组发生新生儿窒息的OR值分别为1.03(95% CI:0.97～1.09)、1.06(95% CI:0.96～1.16)和1.14(95% CI:1.00～1.31).进一步调整孕期增重后,上述OR值分别为1.02(95% CI:0.95～1.09)、1.01(95% CI:0.90～1.13)和1.08(95% CI:0.92～1.28).以孕期体重增加≥0.5 kg/wk组作为参照,孕期体重增加为0.3～kg/wk和＜0.3 kg/wk组发生新生儿窒息的OR值分别为1.06(95% CI:1.01～1.12)和1.09(95% CI:1.02～1.20).结论 孕期体重增加＜0.5 kg/wk加大新生儿窒息发生的危险,提示临床上宜对妇女孕前的BMI进行监测,并据此进行孕前指导和孕期管理,以保持合理的孕期体重,降低新生儿窒息的发生危险.
目的 瞭解孕前體重指數(BMI)、孕期體重增加與新生兒窒息髮生危險的關繫.方法 數據來自"中美預防齣生缺陷和殘疾閤作項目"中嘉興地區的圍產保健鑑測數據庫.研究對象為1995-2000年在嘉興地區參加婚前/孕前體檢且分娩單胎活產兒孕滿20週的83 030名孕產婦.運用χ2檢驗或趨勢χ2檢驗比較不同BMI組或其他特徵人群新生兒窒息髮病率的差彆,利用多元logistic迴歸分析孕前BMI、孕期體重增加與新生兒窒息髮生危險之間的關繫.結果 新生兒窒息髮病率為11.3%(95% CI:11.1%～11.6%).新生兒窒息髮病率從BMI＜18.5 kg/m2組的11.0%(95% CI:10.5%～11.5%)逐漸升至BMI≥25.0 kg/m2組的12.9%(95% CI:11.6%～14.4%),自孕期體重增加＜0.3 kg/wk的12.4%(95% CI:11.9%～13.0%)逐漸降至≥0.5 kg/wk的10.6%(95% CI:10.1%～11.0%).孕前BMI≥25.0 kg/m2組的新生兒重度窒息髮生率高于BMI更低組.在調整瞭地區、年齡、文化程度、職業、產次、產前檢查次數、孕期高危因素、產時高危因素、孕週和齣生體重後,以BMI＜18.5 kg/m2組為參照組,BMI為18.5～22.9 kg/m2、23.0～24.9 kg/m2和≥25.0 kg/m2組髮生新生兒窒息的OR值分彆為1.03(95% CI:0.97～1.09)、1.06(95% CI:0.96～1.16)和1.14(95% CI:1.00～1.31).進一步調整孕期增重後,上述OR值分彆為1.02(95% CI:0.95～1.09)、1.01(95% CI:0.90～1.13)和1.08(95% CI:0.92～1.28).以孕期體重增加≥0.5 kg/wk組作為參照,孕期體重增加為0.3～kg/wk和＜0.3 kg/wk組髮生新生兒窒息的OR值分彆為1.06(95% CI:1.01～1.12)和1.09(95% CI:1.02～1.20).結論 孕期體重增加＜0.5 kg/wk加大新生兒窒息髮生的危險,提示臨床上宜對婦女孕前的BMI進行鑑測,併據此進行孕前指導和孕期管理,以保持閤理的孕期體重,降低新生兒窒息的髮生危險.
목적 료해잉전체중지수(BMI)、잉기체중증가여신생인질식발생위험적관계.방법 수거래자"중미예방출생결함화잔질합작항목"중가흥지구적위산보건감측수거고.연구대상위1995-2000년재가흥지구삼가혼전/잉전체검차분면단태활산인잉만20주적83 030명잉산부.운용χ2검험혹추세χ2검험비교불동BMI조혹기타특정인군신생인질식발병솔적차별,이용다원logistic회귀분석잉전BMI、잉기체중증가여신생인질식발생위험지간적관계.결과 신생인질식발병솔위11.3%(95% CI:11.1%～11.6%).신생인질식발병솔종BMI＜18.5 kg/m2조적11.0%(95% CI:10.5%～11.5%)축점승지BMI≥25.0 kg/m2조적12.9%(95% CI:11.6%～14.4%),자잉기체중증가＜0.3 kg/wk적12.4%(95% CI:11.9%～13.0%)축점강지≥0.5 kg/wk적10.6%(95% CI:10.1%～11.0%).잉전BMI≥25.0 kg/m2조적신생인중도질식발생솔고우BMI경저조.재조정료지구、년령、문화정도、직업、산차、산전검사차수、잉기고위인소、산시고위인소、잉주화출생체중후,이BMI＜18.5 kg/m2조위삼조조,BMI위18.5～22.9 kg/m2、23.0～24.9 kg/m2화≥25.0 kg/m2조발생신생인질식적OR치분별위1.03(95% CI:0.97～1.09)、1.06(95% CI:0.96～1.16)화1.14(95% CI:1.00～1.31).진일보조정잉기증중후,상술OR치분별위1.02(95% CI:0.95～1.09)、1.01(95% CI:0.90～1.13)화1.08(95% CI:0.92～1.28).이잉기체중증가≥0.5 kg/wk조작위삼조,잉기체중증가위0.3～kg/wk화＜0.3 kg/wk조발생신생인질식적OR치분별위1.06(95% CI:1.01～1.12)화1.09(95% CI:1.02～1.20).결론 잉기체중증가＜0.5 kg/wk가대신생인질식발생적위험,제시림상상의대부녀잉전적BMI진행감측,병거차진행잉전지도화잉기관리,이보지합리적잉기체중,강저신생인질식적발생위험.
Objective To assess the relationship between pre-pregnancy body mass index(BMI),weight gain during pregnancy,and the risk of neonatal asphyxia.Methods Data was collected in 6 counties/cities covered by Peri-natal Health Care Surveillance System which was part of a Sino-American cooperative project on neural tube defects prevention established in 1992.The study population consisted of 83 030 women who attended premarital/preconception medical physical examination program and had delivered single live birth with at least 20 gestational weeks from 1995 to 2000 in Jiaxing area,Zhejiang province.Results from the Chi-square test were employed to test the differences in the rates of neonatal asphyxia between groups with different BMI and other characteristics.Multivariate logistic regression method was conducted to examine the association between pre-pregnancy BMI,gestational weight gain,and the risk of asphyxia.Results The average rate of neonatal asphyxia was 11.3%(95% CI:11.1%-11.6%).The rates of neonatal asphyxia among women with BMI＜18.5 kg/m2,18.5-22.9 kg/m2,23.0-24.9 kg/m2,and≥25.0 kg/m2 were 11.0%(95% CI:10.5%-11.5%),11.3%(95% CI:11.1%-11.6%),11.8%(95% CI:11.0%-12.6%),and 12.9%(95% CI:11.6%-14.4%)respectively.The rates of neonatal asphyxia were 12.4% among women with weight gain＜0.3 kg/wk.higher than women with higher weight gain.After adjusting for residencial area,maternal age,educational level,occupation,parity,times of prenatal visit,high-risk experiences during pregnancy,high-risk experiences at time of delivery,gestational week and birth weight,the estimated ORs were 1.03(95% CI:0.97-1.09),1.06(95% CI:0.96-1.16)and 1.14(95% CI:1.00-1.31),respectively.These ORs became 1.02(95% CI:0.95-1.09),1.01(95% CI:0.90-1.13)and 1.08(95% CI:0.92-1.28)after further adjusting the variable "gestational weight gain".The estimated ORs for neonatal asphyxia were 1.06(95% CI:1.01-1.12)for women with weight gain at 0.3-kg/wk and 1.09(95% CI:1.02-1.20)for women with weight gain＜0.3 kg/wk when compared to those with weight gain≥0.5 kg/wk.Conclusion Lower weight gain seemed to have the effect of increasing the risk of neonatal asphyxia.
