广西地区低出生体重儿危险因素分析  

Risk factors analysis for low-birth-weight infants,Guangxi area

作　　者：刘敏雪 付春云[1] 马刚[1] 李颖丰[1] 黄旭华 何仲彪[1] 姚慧[1] 陆香君 胡雪桦[1] 韦萍[1] LIU Min-xue;FU Chun-yun;MA Gang;LI Ying-feng;HUANG Xu-hua;HE Zhong-biao;YAO Hui;LU Xiang-jun;HU Xue-hua;WEI Ping(Children’s Hospital,Maternal and Child Health Hospital of Guangxi Zhuang Autonomous region,Nanning,Guangxi 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院,广西南宁530003

出　　处：《现代预防医学》2021年第1期63-66,共4页Modern Preventive Medicine

基　　金：自治区卫生厅自筹经费科研课题(Z2013259);国家自然科学基金(81760615);广西儿童工作资源中心(2018GXETGZZY);广西临床重点专科(医学检验科)建设项目。

摘　　要：目的分析广西地区低出生体重的危险因素,为制定低出生体重干预措施提供依据。方法本研究为多中心横断面回顾性统计分析研究,以2018年广西大部分地区新生儿为研究对象,病例组共纳入37 010例(占总数91.31%)低出生体重活产儿,对照组随机抽取54 677例正常出生体重活产儿,采用孕产妇个案调查表收集相关孕产妇数据及新生儿资料。用单因素及多因素logistic回归统计低出生体重危险因素。结果单因素分析结果显示,病例组与对照组性别、出生身长、民族、孕周、多胎妊娠、新生儿出生缺陷、产程、孕产妇初检孕周、产检次数、孕次、产次、产后出血量以及孕产妇孕早期(孕13周以前)检测指标包括血红蛋白、舒张压、体重、是否服用叶酸有差异,且差异均具有统计学意义(P<0.001)。将单因素分析中P<0.1的可疑危险因素纳入多因素logistic回归,回归结果表明低出生体重危险因素为性别(OR:1.345,95%CI:1.278~1.415),出生身长(OR:0.250,95%CI:0.244~0.255),住地农村(OR:1.119,95%CI:1.037~1.208),孕次(OR:0.938,95%CI:0.916~0.960),产次(OR:0.859,95%CI:0.825~0.894),孕周(OR:0.587,95%CI:0.576~0.598),出生缺陷(OR:1.627,95%CI:1.304~2.031),孕产妇产检次数(OR:0.959,95%CI:0.951~0.967),多胎妊娠(OR:3.268,95%CI:2.838~3.765),孕产妇孕早期体重(OR:0.989,95%CI:0.986~0.992),孕产妇孕早期是否服用叶酸(OR:0.936,95%CI:0.891~0.985)及孕产妇孕早期舒张压(OR:1.003,95%CI:1.000~1.006)。结论本研究结果提示胎儿方面因素与孕产妇方面因素均可影响新生儿出生体重,可通过加强健康宣教、增强围产期保健管理、必要时积极做好出生缺陷筛查、孕产妇定期产检、保证孕期营养物质供给等措施来降低新生儿低出生体重发生的概率。Objective To analyzerisk factors for low-birth-weight infant(LBWI)so as to provide basis for making intervention policies of LBWI.Methods 37010(91.31%)low birth weight live births were included as case group and 54677 normal birth weight infants were included as control group.Pregnant women and infants’data were collected using case questionnaire.The risk factors were analyzed by univariate analysis and multivariate logistic regression analysis.Results Univariate analysis showed the gender,infants’birth body length,nationality,gestational age,multiple pregnancy,birth defect,birth process time,gestation weeks for the first exam,the frequency of being examined during pregnancy,gravidity,parity,postpartum hemorrhage and hemoglobin,diastolic blood pressure,gravida weight and folic acid taking prior to gestation 13 weeks of LBWI were significant different from the data of control group(P<0.001).Suspicious risk factors(P<0.1 in univariate analysis)were included into the multivariate logistic regression analysis.The results showed the gender(OR:1.345,95%CI:1.278-1.415),infants’birth body length(OR:0.250,95%CI:0.244-0.255),rural residents(OR:1.119,95%CI:1.037-1.208),gravidity(OR:0.938,95%CI:0.916-0.960),parity(OR:0.859,95%CI:0.825-0.894),gestational age(OR:0.587,95%CI:0.576-0.598),birth defect(OR:1.627,95%CI:1.304-2.031),the frequency of being examined during pregnancy(OR:0.959,95%CI:0.951-0.967),multiple pregnancy(OR:3.268,95%CI:2.838-3.765),diastolic blood pressure prior to gestation 13 weeks(OR:1.003,95%CI:1.000-1.006),gravida weight prior to gestation 13 weeks(OR:0.989,95%CI:0.986-0.992)and folic acid taking prior to gestation 13 weeks(OR:0.936,95%CI:0.891-0.985)were risk factors of LBWI.Conclusion Strengthening health education,perinatal health care management,birth defects screening,regular prenatal examinationsand nutrition turnover during pregnancy might be helpful to reduce LBWI incidence.

关 键 词：低出生体重 危险因素 广西地区 

分 类 号：R179[医药卫生—妇幼卫生保健]