中国新生儿低出生体重危险因素的系统评价和Meta分析  

Risk factors of low birth weight in Chinese neonates:a systematic review and Meta-analysis

作　　者：刘毅 尹文琴 杨金友 LIU Yi;YIN Wenqin;YANG Jinyou(School of Health and Rehabilitation,Jiangsu Nursing Vocational College,Huian 223300,China)

机构地区：[1]江苏护理职业学院健康与康复学院,江苏淮安223300

出　　处：《东南大学学报（医学版）》2020年第6期730-736,共7页Journal of Southeast University(Medical Science Edition)

基　　金：江苏省高校自然科学基金资助项目(17KJD190001);江苏省医学科技发展基金资助项目(JZ201705)。

摘　　要：目的:探讨中国新生儿低出生体重的危险因素,为新生儿低出生体重的预防提供参考依据。方法:收集2008—2019年关于中国新生儿低出生体重危险因素的病例对照研究文献进行Meta分析,由两名研究人员独立提取数据,按照纽卡斯尔渥太华(NOS)量表对纳入文献进行质量评价,异质性检验采用Q检验和I 2统计量,敏感性分析采用不同模型分析同一资料,发表偏倚采用Egger s检验和剪补法评估。结果:共纳入22篇病例对照研究文献,其中病例组样本9396例,对照组样本14357例。Meta分析结果显示,中国新生儿低出生体重的危险因素是孕周不满37周(OR=17.165,95%CI为7.516~39.203)、孕母高龄(OR=1.392,95%CI为1.078~1.797)、妊娠期高血压(OR=3.591,95%CI为2.613~4.963)、母亲从事体力劳动职业(OR=1.402,95%CI为1.075~1.829)、孕期紧张焦虑(OR=1.609,95%CI为1.237~2.092)、孕期营养不良(OR=3.703,95%CI为2.099~6.531)、孕早期阴道出血(OR=1.842,95%CI为1.110~3.056)、不良孕产史(OR=1.329,95%CI为1.064~1.660)。效能检验结果显示除孕母高龄外,其余因素的效能均大于80%。结论:孕周不满37周、孕母高龄、妊娠期高血压、母亲从事体力劳动职业、孕期紧张焦虑、孕期营养不良、孕早期阴道出血、不良孕产史可能增加新生儿低出生体重的发生风险。Objective:To investigate the risk factors for low birth weight in Chinese neonates,and to provide reference for prevention of low birth weight.Methods:Systematic review of case-control studies published between 2008 and 2019 regarding risk factors for low birth weight in Chinese neonates was performed by Meta-analysis.Data were extracted independently by two researchers.The quality of selected studies was evaluated according to the NOS scale.Chi-square tests of homogeneity and the I 2 statistic were used to evaluate the heterogeneity of the included studies.Sensitivity analysis was conducted by using different models to analyze the same data.Publication bias was assessed by Egger s tests and the trim and filling method.Results:A total of 22 case-control studies were selected,including 9396 cases and 14357 controls.Results of the Meta-analysis show that the risk factors of low birth weight in Chinese neonates were as follows:gestation<37 weeks(OR=17.165,95%CI 7.516-39.203),mother with advanced age(OR=1.392,95%CI 1.078-1.797),gestational hypertension(OR=3.591,95%CI 2.613-4.963),occupation of the mother as labor-insensive workers(OR=1.402,95%CI 1.075-1.829),stress and anxiety during pregnancy(OR=1.609,95%CI 1.237-2.092),malnutrition during pregnancy(OR=3.703,95%CI 2.099-6.531),vaginal bleeding during early pregnancy(OR=1.842,95%CI 1.110-3.056),and abnormal pregnancy history(OR=1.329,95%CI 1.064-1.660).The power analysis revealed that the power of all risk factors was greater than 80%except for the age factor.Conclusion:Gestation<37 weeks,mother with advanced age,gestational hypertension,occupation of mother as labor-intensive workers,stress and anxiety during pregnancy,malnutrition during pregnancy,vaginal bleeding in early pregnancy,and abnormal pregnancy history may increase the risk of low birth weight in Chinese neonates.

关 键 词：新生儿 低出生体重 危险因素 META分析 

分 类 号：R722[医药卫生—儿科]