广东巨大儿发病率调查及高危因素分析  

Analysis of Mobidity and Risk Factors of Macrosomia in Guangdong

作　　者：陈海天[1] 胡明晶[1] 王广涵[1] 祝文晶[1] 王子莲[1] 崔咏怡 高结坤 魏晓萍 温济英[5] 黎箐[6] 范建辉[7] 陈宏霞[8] 韩凤珍[9] 潘石蕾[10] 范舒舒[11] 王蕴慧[12] 胡淑君[13] 

机构地区：[1]中山大学附属第一医院妇产科,广东广州510080 [2]广州市妇女儿童医疗中心,广东广州510623 [3]番禺区何贤纪念医院,广东广州511400 [4]深圳市人民医院,广东深圳518020 [5]广东省妇幼保健院,广东广州510010 [6]江门市妇幼保健院,广东江门529000 [7]中山大学附属第三医院,广东广州510630 [8]中山市人民医院,广东中山528403 [9]广东省人民医院,广东广州510080 [10]南方医科大学珠江医院,广东广州510282 [11]韶关市粤北人民医院,广东韶关512026 [12]中山大学孙逸仙纪念医院,广东广州510120 [13]广州医学院附属第一医院,广东广州510120

出　　处：《中山大学学报（医学科学版）》2012年第2期276-280,F0003,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省科技计划项目(2009B030801099)

摘　　要：【目的】调查广东巨大儿发生率及探讨其高危因素。【方法】收集中山大学附属第一医院等广东13所大型医院产科2010年10月至2010年11月住院分娩的巨大儿(≥4000 g)共222例作为研究组,随机抽取同期正常体质量(2 500～3 999 g)的新生儿414例作为对照组。计算巨大儿发生率,比较两组间孕妇年龄、孕次、产次、身高、孕前体质量、产前体质量、孕期增重、孕周、分娩方式、新生儿体质指标、孕妇及新生儿并发症等情况,统计分析巨大儿的相关因素及高危因素。【结果】巨大儿共222例,总发生率为2.78%;两组间孕妇孕期增重有统计学差异[对照组(15±5)kg vs巨大儿组(18±5)kg,P<0.05];巨大儿组中妊娠期糖尿病(16.9%vs 5.6%,P<0.01)、羊水过多(7.8%vs 1.2%,P<0.01)的发生率更高;巨大儿组顺产率更低(20.1%vs 47.5%,P<0.05),手术产率更多(78.5%vs 51.0%,P<0.01);巨大组和对照组的男女婴比例有显著差异(146/76 vs 229/185,P<0.01);头围也有统计学差异[(35.75±1.07)cm vs(33.70±1.53)cm,P<0.01]。分娩巨大儿的相关因素为孕周、孕次、身高、孕前体质量、孕前BMI、产前体质量、产前BMI、孕期增重等;分娩巨大儿的高危因素为年龄、孕周、产前体质量、妊娠期糖尿病等。【结论】广东巨大儿发生率约为2.78%,高危因素为年龄、孕周、产前体质量、妊娠期糖尿病等;在具有分娩巨大儿高危因素的孕妇当中,要注意筛查巨大儿,特别是在四步触诊临床估计胎重及超声测量中。【Objective】 To investigate the morbidity of macrosomia and to explore its risk factors in Guangdong.【Methods】A total of 222 cases of macrosomia（≥4000 g） were collected as the study group from 13 large hospitals such as First Affiliated Hospital of Sun Yat-sen University in Guangdong during Oct 2010 to Nov 2010.Meanwhile,414 neonates of normal birth weight（2500-3999 g） were gathered as the control group.To calculate the morbidity of macrosomia and to compare their mothers age,gravidity,parity,height,pregestational weight,prepartum weight,weight gain,geatational weeks,mode of delivery,neonatal body index and complication;To analyze the related factors and risk factors of macrosomia.【Results】 There were 222 cases of macrosomia and its morbidity was 2.78 %;Weight gain were different between the control group and the study group [（14.59 ± 4.47） kg vs（17.73 ± 5.08） kg,P 0.05];In the study group,incidence of gestational diabetes mellitus（16.9 % vs 5.6 %,P 0.01） and polyhydramnios（7.8 % vs 1.2 %,P 0.01） was higher;Incidence of vaginal spontanese delivery（20.1% vs 47.5%,P 0.05） was lower and incidence of c-section was higher（78.5 % vs 51.0 %,P 0.01）;There was significant difference in gender distribution between the study group and the control group（146/76 vs 229/185,P 0.01）;So was head circumstance [（35.75 ± 1.07） cm vs（33.70 ± 1.53） cm,P0.01].Related factors of macrosomia were gestational weeks,gravidity,height,pregestational weight,pregestational BMI,prepartum weight,prepartum BMI and weight gain;Risk factors of macrosomia were age,geatational weeks,prepartum weight and gestational diabetes mellitus.【Conclusion】 The morbidity of macrosomia is 2.78 % in Guangdong and its risk factors were age,gestational weeks,prepartum weight and gestational diabetes mellitus;Macrosomia should be paid enough attention to and estimated by four maneuvers of Leopold and ultrasound in those pregnant women of risk factors.

关 键 词：巨大儿 新生儿 妊娠期糖尿病 剖宫产 

分 类 号：R714.7[医药卫生—妇产科学]