母亲既往生育史对低出生体质量儿发生的影响  

Influence of previous reproductive history on low birth weight infants

作　　者：王卫凯[1] 杨兰[1] 蔺茹[2] 吴珠明[2] 

机构地区：[1]兰州大学公共卫生学院,730050 [2]甘肃省妇幼保健院,兰州730050

出　　处：《中华妇幼临床医学杂志（电子版）》2015年第4期521-526,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨母亲既往生育史对低出生体质量（LBW）儿发生的影响。方法选择2009年2月至2010年12月于甘肃省妇幼保健院产科娩出的375例LBW儿为研究对象,纳入LBW儿组（n=375）。选择同期于本院产科娩出的5 157例正常出生体质量儿为对照组（n=5 157）。本研究遵循的程序符合甘肃省妇幼保健院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象监护人的知情同意,并与之签署临床研究知情同意书。比较两组母亲既往生育史对LBW儿发生的影响。结果 1既往有怀孕史（孕次≥1时OR=1.46,95%CI：1.18~1.81;孕次≥2时OR=1.80,95%CI：1.40~2.32）、生产史（产次=1时OR=1.65,95%CI：1.29~2.11;产次≥2时OR=2.68,95%CI：1.71~4.20）、多次（≥2次）自然流产史（OR=2.70,95%CI：1.67~4.35）、既往分娩早产儿（OR=6.32,95%CI：2.86~13.97）、分娩LBW儿史（OR=4.62,95%CI：1.48~14.40）及不良孕产史（OR=3.26,95%CI：2.07~5.14）均是LBW儿发生的危险因素。而既往多次自然流产史（aOR=1.08;95%CI：0.49~2.39）、分娩早产儿史（aOR=1.00,95%CI：0.31~3.19）与不良孕产史（aOR=1.51,95%CI：0.64~3.55）是LBW儿发生的独立危险因素。2孕次、产次、自然流产史、分娩早产儿史及不良孕产史均是早产LBW儿发生的危险因素（OR=1.72,95%CI：1.34~2.20;OR=1.99,95%CI：1.54~2.58;OR=1.80,95%CI：1.30~2.50;OR=8.32,95%CI：3.75~18.43;OR=3.57,95%CI：2.18~5.85）。既往分娩LBW儿是足月LBW儿的独立危险因素（aOR=7.93,95%CI：1.72~36.46）。结论 LBW儿的发生与母亲的孕次、产次、多次自然流产史、既往分娩LBW儿等生育史有密切关系,而与既往分娩早产儿史、不良孕产史等相关性较小。对上述妇女再次怀孕时,应做好孕前、孕期保健服务,以有效减少LBW的发生。Objective To explore the influence of previous reproductive history on low birth weight（LBW）infants.Methods From February 2009 to December 2010,a total of 375 hospitalized LBW infants were included in the study as LBW group（n=375）.Meanwhile 5 157 normal birth weight infants in the same hospital were chosen as control group（n=5 157）.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Gansu Provincial Maternity and Child-care Hospital.Informed consent was obtained from each participants′parents.The effects of the pregnancy previous reproductive history were compared between two groups.Results 1The gravidity（gravidity≥1,OR=1.46,95%CI：1.18-1.81;gravidity≥2,OR=1.80,95%CI：1.40-2.32）,parity（parity=1,OR=1.65,95%CI：1.29-2.11;parity≥2,OR=2.68,95%CI：1.71-4.20）,multiple spontaneous abortion history（OR=2.70 95%CI：1.67-4.35）,previous delivery history of preterm infants（OR=6.31,95%CI：2.86-13.97）and LBW infants（OR=4.62,95%CI：1.48-14.40）,adverse pregnancy history（OR=3.26,95%CI：2.07-5.14）were risk factors of LBW.The multiple spontaneous abortion history（aOR=1.08,95%CI：0.49-2.39）,previous delivery history of preterm infants（aOR=1.00,95%CI：0.31-3.19）and adverse pregnancy history（aOR=1.5;95%CI：0.64-3.55）were the independent risk factors of LBW.2The gravidity,parity,spontaneous abortion history,previous delivery history of preterm infants and adverse pregnancy history were the risk factors of preterm infants with LBW（OR=1.72,95%CI：1.34-2.20;OR=1.99,95%CI：1.54-2.58;OR=1.80,95%CI：1.30-2.50;OR=8.32,95%CI：3.75-18.43;OR=3.57,95%CI：2.18-5.85）.The independent risk factors of term infants with LBW was previous delivery history of LBW infants（aOR=7.93,95%CI：1.72-36.46）.Conclusions The occurrence of LBW infants had strong relationship with the previous reproductive history of their mother,such as gravidity,parity,mutiple spontaneous abortion history,previous delivery history of LBW infants,and had little r

关 键 词：低出生体质量儿 生育史 病例对照研究 LOGISTIC回归 

分 类 号：R714.7[医药卫生—妇产科学]