2013年天津市新生儿低出生体重发生率及其影响因素研究
摘要
目的分析天津市活产新生儿低出生体重发生率及其影响因素,为政策干预和预防提供理论依据。方法从天津市妇幼卫生信息系统导出出生日期为2013年1月1日至2013年12月31日的110 131名活产新生儿及其父母信息数据。采用SPSS 18.0软件进行χ~2检验,采用多因素logistic回归分析探讨低出生体重的影响因素。结果 2013年天津市16家区县妇幼保健机构共登记天津籍活产儿110 131名,低出生体重发生率为4.0%。logistic回归分析结果显示,女婴(OR=1.51,95%CI:1.35～1.68)、早产(OR=39.34,95%CI:35.13～44.05)、产妇孕期增重<10 kg(OR=1.55,95%CI:1.35～1.79)、多胎(OR=11.32,95%CI:9.51～13.48)、健康状况评估结果为一般(OR=1.97,95%CI:1.54～2.51)或差(OR=97.64,95%CI:64.24～148.41)、梅毒RPR检测结果为阳性(OR=3.06,95%CI:1.42～6.57)、产前筛查为高风险(OR=1.63,95%CI:1.33～2.00)是胎儿发生低出生体重的危险因素;新生儿母亲现住郊区(近郊OR=0.73,95%CI:0.62～0.84;远郊OR=0.82,95%CI:0.69～0.99)、孕次在2次及以上(OR=0.84,95%CI:0.72～0.98)或产次在2次及以上(OR=0.66,95%CI:0.54～0.79)是胎儿发生低出生体重的保护性因素。结论 2013年天津市新生儿低出生体重发生率略低于全国平均水平,应识别重点干预地区、高危人群,针对性地开展低出生体重干预,降低新生儿低出生体重发生率。
引文
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[22]王娟,任爱国,叶荣伟,等.低出生体重与孕期血红蛋白浓度的关系[J].中国生育健康杂志,2009,20(2):75-78.
[23]苏莎,黄玲玲.孕妇缺铁性贫血对新生儿出生体重的影响[J].广西医科大学学报,2015,32(6):934-936.
[24]王娟,任爱国,叶荣伟,等.低出生体重与孕期血红蛋白浓度的关系[J].中国生育健康杂志,2009,20(2):75-78.
[2]谢幸,苟文丽,林仲秋,等.妇产科学[M].8版.北京:人民卫生出版社,2015:142.
[3]李晓松,陈峰,郝元涛,等.卫生统计学[M].8版.北京:人民卫生出版社,2017:322.
[4]王宏蕾.早期新生儿死亡578例临床研究[J].河北医学,2014,20(12):2127-2129.
[5] Chen Y,Li G,Ruan Y,et al. An epidemiological survey on low birth weight infants in China and analysis of outcomes of full-term low birth weight infants[J]. BMC Pregnancy Childbirth,2013,13(242):1-9.
[6]齐秀英,徐汉猛.低出生体重儿的发生率及相关危险因素研究[J].中国妇幼保健,2005,20(3):315-317.
[7]张黎,赵斌,王艳,等.低出生体重儿发生率及危险因素分析[J].中国妇幼保健,2009,24(28):3972-3973.
[8]黄小云,刘惠龙,麦慧芬,等.不同分娩年龄、不同胎龄低出生体重儿发生率研究[J].中国妇幼卫生杂志,2015,6(4):13-16.
[9]姜海利,王欣,张为远.北京地区低出生体重儿的现状调查[J].中国妇幼保健,2014,29(10):1586-1589.
[10] WHO. Proposed Global targets for maternal,infant and young child nutrition[EB/OL].(2012-02-06)[2018-3-10]. http://www.who.int/nutrition/events/2012_proposed_globaltargets_backgroundpaper.pdf.
[11]裘蕾,孔元原,杨海河. 2013年北京市活产新生儿出生体重情况及影响因素分析[J].中国儿童保健杂志,2015,23(5):539-542.
[12]傅秀霞.低出生体重儿源自母亲的危险因素分析[J].中国基层医药,2002,9(12):1104-1105.
[13] Shinohara S,Hirai M,Hirata S,et al. Relation between low 50-g glucose challenge test results and small-for-gestational-age infants[J]. J Obstet Gynaecol Res,2015,41(11):1752-1756.
[14] Rogne T,Jacobsen GW. Association between low blood glucose increase during glucose tolerance tests in pregnancy and impaired fetal growth[J]. Acta Obstet Gynecol Scand,2014,93(11):1160-1169.
[15] Liu J,Leng J,Tang C,et al. Maternal glucose level and body mass index measured at gestational diabetes mellitus screening and the risk of macrosomia:results from a perinatal cohort study[J]. BMJ Open,2014,4(5):e004538.
[16] Leng JJ,Liu G,Wang J,et al. The association between glucose challenge test level and fetal nutritional status[J]. J Matern Fetal Neonatal Med,2014,27(5):479-483.
[17] Winkvist A,Stenlund H,Hakimi M,et al. Weight-gain patterns from prepregnancy until delivery among women in Central Java,Indonesia[J]. Am J Clin Nutr,2002,75(6):1072-1077.
[18] Gaillard R,Durmus B,Hofman A,et al. Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy[J].Obesity,2013,21(5):1046-1055.
[19] Kandel KP,Kafle S. Risk Factors Associated with low birth weight among deliveries at Bharatpur Hospital[J]. J Nepal Health Res Counc,2017,15(2):169-173.
[20]束莉.孕期增重、新生儿出生体重的影响因素分析及与膳食关系的研究[D].合肥:安徽医科大学硕士论文集,2010:62-64.
[21] Hickey CA. Sociocultural and behavioral influences on weight gain during pregnancy[J]. Am J Clin Nutr,2000,71(5 Suppl):1364S-1370S.
[22]王娟,任爱国,叶荣伟,等.低出生体重与孕期血红蛋白浓度的关系[J].中国生育健康杂志,2009,20(2):75-78.
[23]苏莎,黄玲玲.孕妇缺铁性贫血对新生儿出生体重的影响[J].广西医科大学学报,2015,32(6):934-936.
[24]王娟,任爱国,叶荣伟,等.低出生体重与孕期血红蛋白浓度的关系[J].中国生育健康杂志,2009,20(2):75-78.