孕早期呕吐与不良妊娠结局关系出生队列研究  

Relationship between first trimester vomiting and adverse pregnancy outcomes:a birth cohort study

作　　者：王磊[1] 陶芳标[1] 郝加虎[1] 苏普玉[1] 孙蕾[1] 严双琴[2] 徐叶清[2] 

机构地区：[1]安徽人口健康与优生省级实验室安徽医科大学公共卫生学院儿少卫生与妇幼保健学系,安徽合肥230032 [2]安徽省马鞍山市妇幼保健院

出　　处：《中国公共卫生》2013年第7期940-944,共5页Chinese Journal of Public Health

基　　金：国家科技支撑计划(2006BAI05A03);省级实验室项目(1206c0805027);安徽省科技攻关项目(11010402166)

摘　　要：目的探讨孕早期呕吐与3种不良妊娠结局(早产、低出生体重、小于胎龄儿)的关系。方法样本人群来自于安徽者马鞍山市出生队列,以2008年10月—2010年10月在马鞍山市妇幼保健机构孕早期建卡并随访到分娩记录的5 084名孕妇为研究对象,采用χ2检验和logistic回归模型分析孕早期不同呕吐程度与3种不良妊娠结局的关系。结果队列中4 653名单胎活产儿母亲在孕早期发生剧吐的有175人,占3.8%;轻微呕吐有2 937人,占63.1%,无呕吐有1 541人,占33.1%;多因素logistic回归分析结果显示,孕早期发生轻微呕吐是发生小于胎龄儿的保护因素(RR=0.66,95%CI=0.45～0.96);孕早期剧呕是发生小于胎龄儿的危险因素(RR=2.76,95%CI=1.51～5.05)。结论孕早期轻微呕吐和剧吐对小于胎龄儿的发生有不同影响。Objective To examine the effect of first trimester vomiting on adverse pregnancy outcomes including small for gestational age（SGA）,premature birth（PB）,and low birth weight（LBW）.Methods Subjects were 5 084 pregnant women who had joined in the Ma’anshan Birth Cohort Study and delivered between October 2008 and October 2010.The relationships between different vomiting and adverse pregnancy outcomes were evaluated by chi-square analysis and non-conditional logistic regression.Results Of the 4 653 women with singleton alive pregnancy,2 937 had nausea and vomiting,175 had hyperemesis gravidarum（HG）,and 1 541 did not experience vomiting.After adjusting for several risk factors,mothers with nausea and vomiting in pregnancy（NVP） in the first trimester had a 0.66 time（relative risk=0.66,95% confidence interval：0.45-0.96）of giving birth to small for gestational age infants compared to the women with no vomiting in pregnany.The mothers with HG had a 2.76 times（RR=2.76,95%CI：1.51-5.05） of giving birth to small for gestational age infants compared to the women with no vomiting in pregnancy.Conclusion No vomiting or HG during the first trimester of pregnancy have different effects on small for gestational age.

关 键 词：孕期呕吐 妊娠剧吐 早产 低出生体重 小于胎龄儿 

分 类 号：R714[医药卫生—妇产科学]