孕妇孕期补充钙剂对新生儿低出生体质量的影响  

The association between maternal calcium supplementation during pregnancy and low birth weight

作　　者：刘阿敏 武文韬 张彬艳 刘美丹 刘丹朦 李姗姗 颜虹 党少农 LIU Amin;WU Wentao;ZHANG Binyan;LIU Meidan;LIU Danmeng;LI Shanshan;YAN Hong;DANG Shaonong(Department of Epidemiology and Biostatistics,School of Public Health,Xi'an Jiaotong University Health Science Center,Xi'an 710061,China)

机构地区：[1]西安交通大学医学部公共卫生学院流行病与卫生统计学系

出　　处：《国外医学（医学地理分册）》2019年第3期253-259,共7页Foreign Medical Sciences：Section of Medgeography

基　　金：国家自然科学基金资助项目(No.81230016);陕西省卫生和计划生育委员会出生缺陷防治课题(No.sxwsjswzfcght2016-013)

摘　　要：目的探讨孕妇孕期补充钙剂和新生儿低出生体质量(low birth weight,LBW)发生之间的关系。方法采用2013年8—11月在陕西省10个城区和20个县收集的多阶段分层随机抽样横断面调查数据。在控制社会人口学特征及孕期相关因素的情况下,运用Logistic回归模型分析孕妇孕期补充钙剂和新生儿LBW的关系,并通过分层分析,探讨在不同生育年龄、不同文化程度、不同居住地以及不同职业间,孕妇孕期补充钙剂对LBW影响的差异。结果27542名调查对象中,LBW发生率为3.13%,孕期未补充钙剂的孕妇其子代LBW发生率为3.77%,孕期补充钙剂的孕妇其子代LBW发生率为2.77%。从孕中期、孕晚期开始补充钙剂的孕妇其子代LBW发生率分别为2.86%、2.25%。建立非条件多因素Logistic回归模型后发现,与整个孕期未补充钙剂相比,孕期补充钙剂是LBW的保护因素(aOR=0.80,95%CI:0.69~0.93);从孕中期、孕晚期开始补充钙剂的孕妇其子代LBW的发生风险是孕期未补充钙剂的0.82倍和0.64倍(模型3);分层分析显示,在农村地区、农民孕妇中补充钙剂可以更加显著地降低LBW的发生(aOR=0.81,95%CI:0.69~0.96)(aOR=0.74,95%CI:0.62~0.87)。结论陕西省孕妇孕期补充钙剂尤其是从孕中晚期开始补充,与低出生体质量的发生呈负相关。在农村地区和农民孕妇可通过补充钙剂降低新生儿低出生体质量的发生。Objective To investigate the relationship between calcium supplementation during pregnancy and the risk of low birth weight(LBW).Methods This study used data from a large-scale cross-sectional survey conducted between August to November 2013 in Shaanxi Province of Northwest China.Women were recruited using stratified multistage cluster random sampling method in 10 urban districts and 20 counties of Shaanxi Province.Logistic regression model was used to analyze the association between calcium supplementation and LBW after controlling the demographic characteristics and health-related factors during pregnancy.Stratified analysis was used to explore the association between calcium supplementation and LBW according to maternal age,educational level,residence,and occupation.Results Totally 27 542 eligible women were included in the final analysis.The incidence of LBW for the overall population,the calcium supplements nonusers,and the calcium supplements users were 3.13%,3.77%,and 2.77%,respectively.Among calcium supplements users,the incidence of LBW for women who commenced calcium supplements from the second or third trimester were 2.86% and 2.25%,respectively.Unconditional multivariate Logistic regression analysis showed that calcium supplementation during pregnancy was associated with decreased risk of LBW(aOR=0.80,95%CI:0.69 to 0.93).This association was observed among pregnant women who started to consume calcium supplements at the second trimester(aOR=0.82,95%CI:0.69 to 0.97) as well as the third trimester(aOR=0.64,95%CI:0.47 to 0.87).Stratified analyses presented that the significant association between calcium supplementation and the risk of LBW was found in rural residents(aOR = 0.81,95%CI:0.69 to 0.96) and farmers(aOR=0.74,95%CI:0.62 to 0.87).Conclusion Calcium supplementation during pregnancy,especially started from the third trimester,was associated with reduced risk of LBW among pregnant women in Shaanxi province,particularly among those who were rural residents and farmers.

关 键 词：钙剂 低出生体质量 孕期 

分 类 号：R445[医药卫生—影像医学与核医学]