孕前因素对新生儿出生重量指数的影响  

Pre-conceptive factors on the birth ponderal index

作　　者：蔡畅[1] 周书进 文师吾[1] 郭亚伟[1] 谭红专[1] 王莎亚[1] 罗美玲[1] 胡丽[1] 何玥[1] 柳祎[1] 沈琳[1] 

机构地区：[1]中南大学公共卫生学院,长沙410008 [2]湖南省浏阳市妇幼保健院

出　　处：《中华流行病学杂志》2013年第4期342-345,共4页Chinese Journal of Epidemiology

基　　金：国家自然科学基金（30872167）

摘　　要：目的探讨新生儿出生重量指数（PI）的孕前影响因素。方法采用前瞻性队列研究方法，通过整群随机抽样，从湖南省浏阳市37个乡镇中随机抽取14个乡镇，自2008年4月始收集所有在妇幼保健机构登记建册，并计划1年内生育且愿意抽血检测的妇女作为研究对象组成孕前队列，随访追踪其妊娠结局。单因素分析采用χ2检验和相关分析，多因素分析采用logistic回归分析。结果进入队列1368人，其中已怀孕产生单胎活产妊娠结局且资料完整者611人。在611名新生儿中，平均出生体重（3．26±0.43）kg，出生身长（50±0.46）cm，出生PI为26．08±3．43。多因素分析显示，孕前经济收入水平（OR=6．920，95％CI：1．089～43．974）和血清皮质醇水平（OR=5．121，95％CI：0．886～29．611）是低PI新生儿的危险因素；低密度脂蛋白胆固醇（LDL—C）水平（OR=3．736，95％CI：0．848—16．461）和中心性肥胖（OR=6．846，95％CI：1．441—32．532）是高PI新生儿的危险因素；文化程度（OR=0.169，95％CI：0．029～0．995）和胰岛素水平（OR=0.141，95％CI：0.016—1．277）是高PI新生儿的保护因素。结论新生儿出生PI与孕前经济收入水平、文化程度、腰围及胰岛素、LDL-C和皮质醇水平有关。育龄妇女在孕前如能检测相关指标，并通过运动、饮食等途径进行调整，可预防非正常PI新生儿的出生。Objective To analyze the pre-conceptive factors on birth ponderal index （PI）. Methods Fourteen towns were selected randomly from the 37 towns of Liuyang county, Hunan province, through cluster sampling in a prospective cohort study. Information was collected on all the women registered at the Maternity and Child Care Departments, and were planning to give birth in the coming year plus willing to receive a blood test and then followed-up until delivery. Single factor analysis would involve chi-square test and correlation analysis, while the multiple-factor analysis would adopt binary logistic regression method. Results A total of 1368 women were recruited in the cohort and 611 of them had a delivery of one child. Means of birth weight, birth length, and birth PI were （3.26 ± 0.43 ） kg, （50±0.46） cm and 26.08 ±3.43, respectively. Data from the multiple stepwise regression analysis showed that income （OR=6.920, 95% CI： 1.089-43.974） and cortisone levels （OR=5.121,95% CI： 0.886-29.611） were related to low PI, while LDL-C （OR=3.736, 95% CI： 0.848-16.461） , waistline （OR=6.846, 95% CI： 1.441-32.532） , education （OR=0.169, 95% CI： 0.029-0.995）, and insulin （OR=0.141,95% CI： 0.016-1.277）were related to high PI. Conclusion Birth PI was associated with income, waistline, education, insulin, cortisone, and LDL-C. Before conception, women should go through necessary tests and keep a good physical condition to reduce their neonates of having abnormal PI.

关 键 词：新生儿重量指数 孕前影响因素 队列研究 

分 类 号：R7[医药卫生—临床医学] R1