胎盘质量与新生儿出生体质量的相关性研究  

Study on the association between placental weight and neonate’s birth weight

作　　者：沈敏[1] 谈韬[1] 李浩捷 唐墨莲 徐仁应[1] 万燕萍[1] SHEN Min;TAN Tao;LI Hao-jie;TANG Mo-lian;XU Ren-ying;WAN Yan-ping(Department of Clinical Nutrition,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院临床营养科

出　　处：《上海交通大学学报（医学版）》2019年第8期893-897,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市小儿消化与营养重点实验室项目(17DZ2272000)~~

摘　　要：目的·研究胎盘质量与新生儿出生体质量的相关性。方法·以2015年1月—2017年12月于上海交通大学医学院附属仁济医院产科分娩的4 187名新生儿及其母亲为研究对象。将所有纳入研究的新生儿按胎盘质量分为胎盘质量过轻(<P10)、胎盘质量正常(P10~P90)和胎盘质量过重(≥P90)共3组。依据医疗记录,采集新生儿(性别、出生体质量、胎盘质量、出生孕周)和母亲(年龄、孕期体质量增长、第1次产检时血压和血生化指标、产次)的临床数据。采用面对面调查法,收集母亲的身高、教育水平、既往病史及妊娠前体质量指数(6个月内)等相关数据。采用多因素一般线性回归模型(generalized linear model,GLM)研究胎盘质量和新生儿出生体质量的关系。采用Logistic回归模型研究胎盘质量对巨大儿及低体质量儿出生风险的影响。结果·最终纳入2 948名新生儿及其母亲,母亲平均年龄为(29.3±4.0)岁,共计分娩男婴1 552例(52.6%)和女婴1 396例(47.4%);新生儿平均出生体质量为(3 334.4±417.9)g,平均分娩孕周为(38.7±1.3)周。胎盘质量过轻组、胎盘质量正常组和胎盘质量过重组的新生儿平均出生体质量分别为(3 238.1±481.5)g、(3 342.6±395.8)g和(3 449.8±423.8)g,组间差异具有统计学意义(P=0.000)。多因素GLM结果显示,控制分娩孕周、母亲年龄、妊娠前体质量指数、孕期体质量增长等多种混杂因素后,与胎盘质量正常组的新生儿相比,胎盘质量过轻组新生儿出生体质量减少51.4(95%CI为16.0~86.8)g(P=0.000),胎盘质量过重组新生儿出生体质量则增加80.3(95%CI为34.1~126.6)g(P=0.000)。巨大儿和低体质量儿的出生比例分别为4.8%和2.3%;Logistic回归分析结果显示,胎盘质量每增长92.0 g,可导致巨大儿出生风险增加36%(OR=1.36,95%CI为1.13~1.63),而低体质量儿的出生风险则降低42%(OR=0.58,95%CI为0.40~0.82)。结论·胎盘质量与新生儿出生体质量密切相关。Objective·To evaluate the association between placental weight and neonate's birth weight.Methods·A total of 4 187 neonates and their mothers were recruited from Department of Obstetrics,Renji Hospital,Shanghai Jiao Tong University School of Medicine from Jan.2015 to Dec.2017.All the included neonates were divided into three groups based on their placental weights,i.e.,low placental weight group(<P10),normal placental weight group(P10-P90),and high placental weight group(≥P90).Both neonate's(sex,birth weight,placental weight,and delivery week)and maternal(age,gestational weight gain,blood pressure and blood biochemical data at the first checkup,and parity)clinical characteristics were collected based on medical records.Maternal height,educational level,history of diseases,and pre-conception body mass index(BMI,6 months before pregnancy)were obtained via face-to-face inquires by dietitians.Multiple-factorial generalized linear model(GLM)was used to evaluate the association between placental weight and neonate's birth weight.The effects of placental weight on the risk of low-birth weight and macrosomia were detected by Logistic regression model.Results·In the current study,2 948 neonates and their mothers were finally included.The mean age of mothers was(29.3±4.0)years old,and 1 552 baby boys(52.6%)and 1 396 baby girls(47.4%)were delivered.The mean birth weight and mean delivery week of neonates were(3 334.4±417.9)g and(38.7±1.3)weeks.The mean birth weight of low,normal,and high placental weight groups were(3 238.1±481.5)g,(3 342.6±395.8)g,and(3 449.8±423.8)g,respectively,and the differences between three groups were statistically significant(P=0.000).Multiple-factorial GLM showed that after adjustment of a series of potential confounders including delivery week,maternal age,pre-pregnancy BMI,and gestational weight gain,compared with normal placental weight group(as reference group),neonate's birth weight of low placental weight group decreased by 51.4(95%CI 16.0?86.8)g(P=0.000),while it increased by 80.

关 键 词：胎盘质量 出生体质量 巨大儿 低体质量儿 

分 类 号：R714.56[医药卫生—妇产科学]