环境、生物-心理、保健因素对减少低出生体重儿的作用  

The Factors of Environment,Biology-Psychology and Health Care in Prenatal Care and Low Birth Weight:A Case-Control Study

作　　者：陈起燕[1] 陈烈平[2] 张荣莲[1] 陈碧香[1] 陈小梅[1] 林淑钦[1] 

机构地区：[1]福建省妇幼保健院保健部,福州350001 [2]福建医科大学公共卫生学院

出　　处：《中国自然医学杂志》2007年第2期88-92,共5页Chinese Journal of Natural Medicine

基　　金：福建省科技厅重点项目(项目编号2004Y019)

摘　　要：目的探讨环境、生物-心理、保健因素对减少低出生体重儿发生的作用。方法采用回顾性病例-对照研究方法，选择2004年11月至2005年9月在福建省妇幼保健院出生的婴儿及产妇，对在该院分娩的179例产妇于产后24h进行问卷调查和摘取病历。结果变量为新生儿出生体重，采用双侧t检验、卡方检验或确切概率法进行单因素分析，再将有意义的变量进一步入选Logistic回归分析。结果丈夫吸烟与饮酒、丈夫情绪、胎儿性别喜好与居住面积5个环境因素，产妇年龄与身高、产妇孕期情绪等7个生物-心理因素，孕期接受群组健康教育、初检孕周、产前检查次数、胎儿脐血流监测、衣原体检测、支原体检测6个保健因素在病例-对照组中差异均有统计学意义。病例组丈夫吸烟每13半包以上达35．2％，是对照组的2．2倍，病例组丈夫经常饮酒达20．3％，是对照组的2．7倍；病例组19～22岁的产妇占16．2％，是对照组的3．4倍，病例组35岁以上的产妇占9．5％，是对照组的2．5倍（P〈0．01）；病例组孕期处于紧张或抑郁情绪占16．2％，是对照组的2．1倍（P〈0．05）。多元Logistic回归分析结果为丈夫吸烟、丈夫情绪、胎儿性别喜好、群组健康教育、胎儿脐血流监测和衣原体检测等6个因素与低出生体重有关。结论环境、生物-心理因素与低出生体重间存在密切相关性；适宜的孕期保健，即早孕检查、适宜的保健次数和参加了群组孕期健康教育及孕期异常情况监测是干预早产低出生体重发生的重要手段。Objective In order to explore the influences of the factors of environment, biology - psychology and health care on low birth weight and possible intervention targets＇to improve the outcomes from early pregnancy. Methods This case- controlled, retrosDeetive study was conducted based upon a population of lying - in women and infants born during a eleven - month Defied from Nov 2004 to Sep 2005.179 eases of participation in this study was entirely voluntary, and the subjects could withdraw their consent at any point. All subjects were from Fujian Provincial Maternal and Children Health Hospital and recruited and enrolled at 24 hours after delivery. t test, x^2 test and fisher test were used for single factor analysis and Logistic regression for multiple analyses. Results 18 factom, such as paternal tobacco use, paternal alcohol use, paternal mood, gender preference and housing square, maternal age and height, maternal mood, group education participation, early prenatal care, visiting times, adequate umbilical artery blood flow and Chlamydia screen and so on, show significant difference between ease and control group.Paternal tobaeeo use for more than haft package per day in case group is 35.2%, 2.2 times as that in control group, and paternal often alcohol drink in case group is 20.3%, 2.7 times as that in control group, and maternal age at 19 - 22 is 16.2%, 3.4 times as that in control group and ≥35 is 9.5%, 2.5 times as much as that of control group （P 〈 0.01）. The environmental exposures, biology- psychological factors and adequate prenatal care which affect the birth weight of infants include： paternal tobacco use, paternal mood, gender preference, group eduction participation, adequate umbilical artery blood flow and Chlamydia screen result. Conclusion Obtaining adequate prenatal care, such as received more frequent as well as earlier prenatal care and attended the prenatal group education sessions can prevent LBW of preterm. This would confirm the concept that as long as pregnant women receive ade

关 键 词：适宜孕期保健 群组健康教育 低出生体重 

分 类 号：R722[医药卫生—儿科]