中华围产医学杂志
中華圍產醫學雜誌
중화위산의학잡지
Chinese Journal of Perinatal Medicine
2015年
10期
755-760
,共6页
婴儿,出生时低体重%发病率%危险因素
嬰兒,齣生時低體重%髮病率%危險因素
영인,출생시저체중%발병솔%위험인소
Infant,low birth weight%Incidence%Risk factors
目的 探讨我国低出生体重儿(low birth weight infant,LBWI)的影响因素,为减少LBWI发生率、改善其围产结局提供参考. 方法 在中国东北、西北、华北、华中、华东、华南和西南的14个省(自治区、直辖市),抽取39所不同级别的医院,2011年1月1日至12月31日共分娩新生儿112 441例.排除基本数据不完整、妊娠28周前流产、因胎儿畸形等原因引产及胎死宫内者,共纳入103 678例新生儿,进行回顾性分析.查阅病例资料,填写调查表并录入数据.调查内容包括孕产妇年龄、文化程度、身高、体重、孕产次、不良孕产史、妊娠并发症及合并症.采用独立样本t检验、x2检验和多因素非条件Logistics回归进行统计学分析. 结果 103 678例新生儿中,LBWI发生率为7.21％(7 474/103 678),早产儿LBWI发生率为61.43％(5 260/8 562),足月儿LBWI发生率为2.33％ (2 21 4/95 116).单因素分析显示,年龄、文化程度、身高、妊娠前体重指数(body mass index,BMI)、妊娠期增重、脐带长度、吸烟、产次、不良孕产史、糖尿病、早产、妊娠期高血压疾病、贫血、胎膜早破、羊水量异常等因素均与LBWI相关.将单因素分析中P＜0.3的变量纳入非条件二分类Logistic回归分析,结果显示,早产(OR=46.246,95％CI: 41.484～51.555)、妊娠期高血压疾病(OR=5.031,95％CI: 4.325～5.853)、既往死胎≥1次(OR=2.446,95％CI: 1.479～4.044)、羊水过少(OR=2.068,95％CI: 1.659～2.578)、妊娠前体重指数＜ 18.5 (OR=1.637,95％CI: 1.415～1.893)、自然流产≥1次(OR=1.362,95％CI:1.043～1.777)、年龄≤20岁(OR=1.332,95％CI: 1.046～1.695)、贫血(OR=1.230,95％CI:1.017～1.488)、胎膜早破(OR=1.154,95％CI: 1.016～1.311),均为发生LBWI的危险因素;孕妇文化程度越高、妊娠期增重越多、妊娠前BMI越高、身高越高,发生LBWI的概率越低.早产儿中小于胎龄儿发生LBWI的危险因素为孕妇患妊娠期高血压疾病、既往死胎≥1次;孕妇身高越高、妊娠期增重越多,发生LBWI的概率越低. 结论 我国发生LBWI的主要影响因素为早产及妊娠期高血压疾病,此外还与社会经济因素及遗传因素相关.
目的 探討我國低齣生體重兒(low birth weight infant,LBWI)的影響因素,為減少LBWI髮生率、改善其圍產結跼提供參攷. 方法 在中國東北、西北、華北、華中、華東、華南和西南的14箇省(自治區、直轄市),抽取39所不同級彆的醫院,2011年1月1日至12月31日共分娩新生兒112 441例.排除基本數據不完整、妊娠28週前流產、因胎兒畸形等原因引產及胎死宮內者,共納入103 678例新生兒,進行迴顧性分析.查閱病例資料,填寫調查錶併錄入數據.調查內容包括孕產婦年齡、文化程度、身高、體重、孕產次、不良孕產史、妊娠併髮癥及閤併癥.採用獨立樣本t檢驗、x2檢驗和多因素非條件Logistics迴歸進行統計學分析. 結果 103 678例新生兒中,LBWI髮生率為7.21％(7 474/103 678),早產兒LBWI髮生率為61.43％(5 260/8 562),足月兒LBWI髮生率為2.33％ (2 21 4/95 116).單因素分析顯示,年齡、文化程度、身高、妊娠前體重指數(body mass index,BMI)、妊娠期增重、臍帶長度、吸煙、產次、不良孕產史、糖尿病、早產、妊娠期高血壓疾病、貧血、胎膜早破、羊水量異常等因素均與LBWI相關.將單因素分析中P＜0.3的變量納入非條件二分類Logistic迴歸分析,結果顯示,早產(OR=46.246,95％CI: 41.484～51.555)、妊娠期高血壓疾病(OR=5.031,95％CI: 4.325～5.853)、既往死胎≥1次(OR=2.446,95％CI: 1.479～4.044)、羊水過少(OR=2.068,95％CI: 1.659～2.578)、妊娠前體重指數＜ 18.5 (OR=1.637,95％CI: 1.415～1.893)、自然流產≥1次(OR=1.362,95％CI:1.043～1.777)、年齡≤20歲(OR=1.332,95％CI: 1.046～1.695)、貧血(OR=1.230,95％CI:1.017～1.488)、胎膜早破(OR=1.154,95％CI: 1.016～1.311),均為髮生LBWI的危險因素;孕婦文化程度越高、妊娠期增重越多、妊娠前BMI越高、身高越高,髮生LBWI的概率越低.早產兒中小于胎齡兒髮生LBWI的危險因素為孕婦患妊娠期高血壓疾病、既往死胎≥1次;孕婦身高越高、妊娠期增重越多,髮生LBWI的概率越低. 結論 我國髮生LBWI的主要影響因素為早產及妊娠期高血壓疾病,此外還與社會經濟因素及遺傳因素相關.
목적 탐토아국저출생체중인(low birth weight infant,LBWI)적영향인소,위감소LBWI발생솔、개선기위산결국제공삼고. 방법 재중국동북、서북、화북、화중、화동、화남화서남적14개성(자치구、직할시),추취39소불동급별적의원,2011년1월1일지12월31일공분면신생인112 441례.배제기본수거불완정、임신28주전유산、인태인기형등원인인산급태사궁내자,공납입103 678례신생인,진행회고성분석.사열병례자료,전사조사표병록입수거.조사내용포괄잉산부년령、문화정도、신고、체중、잉산차、불량잉산사、임신병발증급합병증.채용독립양본t검험、x2검험화다인소비조건Logistics회귀진행통계학분석. 결과 103 678례신생인중,LBWI발생솔위7.21％(7 474/103 678),조산인LBWI발생솔위61.43％(5 260/8 562),족월인LBWI발생솔위2.33％ (2 21 4/95 116).단인소분석현시,년령、문화정도、신고、임신전체중지수(body mass index,BMI)、임신기증중、제대장도、흡연、산차、불량잉산사、당뇨병、조산、임신기고혈압질병、빈혈、태막조파、양수량이상등인소균여LBWI상관.장단인소분석중P＜0.3적변량납입비조건이분류Logistic회귀분석,결과현시,조산(OR=46.246,95％CI: 41.484～51.555)、임신기고혈압질병(OR=5.031,95％CI: 4.325～5.853)、기왕사태≥1차(OR=2.446,95％CI: 1.479～4.044)、양수과소(OR=2.068,95％CI: 1.659～2.578)、임신전체중지수＜ 18.5 (OR=1.637,95％CI: 1.415～1.893)、자연유산≥1차(OR=1.362,95％CI:1.043～1.777)、년령≤20세(OR=1.332,95％CI: 1.046～1.695)、빈혈(OR=1.230,95％CI:1.017～1.488)、태막조파(OR=1.154,95％CI: 1.016～1.311),균위발생LBWI적위험인소;잉부문화정도월고、임신기증중월다、임신전BMI월고、신고월고,발생LBWI적개솔월저.조산인중소우태령인발생LBWI적위험인소위잉부환임신기고혈압질병、기왕사태≥1차;잉부신고월고、임신기증중월다,발생LBWI적개솔월저. 결론 아국발생LBWI적주요영향인소위조산급임신기고혈압질병,차외환여사회경제인소급유전인소상관.
Objective To investigate the influencing factors of low birth weight infants (LBWI) in China in order to provide evidence for lowering the incidence of LBWI and improving the perinatal outcomes.Methods Clinical data were obtained from 14 different provinces, municipalities or autonomous regions in Northeastern, Northwestern, Northern, Central, Eastern, Southern and Southwestern of China, covering 39 hospitals of different levels.A total of 112 441 newborns were collected from January 1 to December 31 in 2011.After exclusion of those cases with incomplete information, miscarriage before 28 weeks of gestation, induction due to fetal malformation or intrauterine fetal death, 103 678 cases were restrospectively analyzed.Questionnaires were filled out and all data were recorded in computer network databases.Clinical data included maternal age, education background, height, weight, parity, histories of abnormal pregancy and comorbidities and complication.Independent sample t-test, Chi-square test, unvariate and ultivariate unconditional Logistics regression analysis were performed.Results The incidence of LBWI in mainland China was 7.21％ (7 474/103 678), 61.43％ (5 260/8 562) for preterm babies, and 2.33％ (2 214/95 116) for full-term babies.Univariate analysis showed that LBWI were associated with maternal age, education background, height, pregestational body mass index (BMI), weight gain during pregnancy, cord length, smoking, parity, histories of abnormal pregancy, gestational diabetes mellitus (GDM), preterm birth, hypertensive disorders in pregnancy, anemia, premature rupture of membranes and abnormal amniotic fluid volume.The following unconditional binary logistic regression analysis for those factors with P ＜ 0.3 in unvariate analysis showed that preterm birth (OR=46.246, 95％CI: 41.484-51.555), hypertensive disorders during pregnancy (OR=5.031, 95％CI: 4.325-5.853), histories of intrauterine fetal death ≥ 1 times (OR=2.446, 95％CI: 1.479-4.044), oligohydramnios (OR=2.068, 95％CI:1.659-2.578), pregestational BMI ＜ 18.5 (OR=1.637, 95％CI: 1.415-1.893), spontaneous abortion ≥ 1 times (OR=1.362, 95％CI: 1.043-1.777), age ≤ 20 (OR=1.332, 95％CI: 1.046 1.695), anemia (OR=1.230, 95％CI: 1.017-1.488) and premature rupture of membranes (OR=1.154, 95％CI:1.016-1.311) were risk factors for LBWI.The higher the maternal education level, weight gain, BMI and height, the lower the LBWI incidence.The risk factors of LBWI in premature small for gestational age (SGA) infants were hypertensive disorders during pregnancy and histories of intrauterine fetal death ≥ 1 times.The higher the maternal height and weight gain during pregnancy, the lower the incidence of LBWI in premature SGA infants.Conclusions The main influencing factors for LBWI are preterm birth and hypertensive disorders during pregnancy.In addition, LBWI is also associated with socioeconomic and genetic factors.
