母亲围孕期吸烟和饮酒及其交互作用与新生儿低出生体重关联的前瞻性队列研究  

A prospective cohort study on the association of maternal perinatal cigarette smoking,alcohol consumption and their interactions with risk of neonatal low birth weight

作　　者：彭辕 罗曼君 阮霄睿 李柳萱 刘涵君 唐嘉鹏 秦家碧[1] PENG Yuan;LUO Manjun;RUAN Xiaorui;LI Liuxuan;LIU Hanjun;TANG Jiapeng;QIN Jiabi(Department of Epidemiology and Health Statistics,Xiangya School of Public Health,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅公共卫生学院流行病与卫生统计学系,长沙410013

出　　处：《中华疾病控制杂志》2024年第11期1257-1263,1364,共8页Chinese Journal of Disease Control & Prevention

基　　金：国家自然科学基金(82073653,81803313);湖南省杰出青年基金(2022JJ10087)。

摘　　要：目的探究母亲围孕期吸烟和饮酒及其交互作用对新生儿低出生体重(low birth weight,LBW)的影响。方法在湖南省内招募首次参与孕早期产检的孕妇以构建孕早期队列,通过问卷和病历系统收集信息,通过电话随访孕妇以监测LBW等妊娠结局。采用logistic回归分析模型分析母亲围孕期吸烟和饮酒及其交互作用与LBW的关联。采用分层分析评估关联的稳定性。结果共纳入34104对单胎孕妇及新生儿进行分析。新生儿中有3020例被诊断为LBW,发生率为8.9%(95%CI:8.6%~9.2%)。多因素logistic回归分析模型分析结果显示,母亲围孕期主动吸烟(OR=1.428,95%CI:1.147~1.777)、被动吸烟(OR=1.128,95%CI:1.031~1.235)和饮酒(OR=2.297,95%CI:1.949~2.706)均是新生儿LBW的危险因素(均P<0.05)。交互作用分析结果显示,主动吸烟与饮酒存在拮抗效应的交互作用(OR=0.117,95%CI:0.049~0.278)。结论母亲围孕期主动吸烟、被动吸烟和饮酒及其交互作用与新生儿LBW的发生风险有关,提示母亲围孕期应保持健康行为方式,以预防LBW。Objective To assess the effects of maternal cigarette smoking and alcohol consumption and their interactions during periconceptional pregnancy on the risk of low birth weight(LBW)in newborns.Methods Pregnant women attending their initial early prenatal care in Hunan Province were recruited to establish a cohort.Information was collected through questionnaires and medical records,with telephone follow-ups to monitor pregnancy outcomes including LBW.The logistic regression analysis was applied to assess the associations of maternal periconceptional cigarette smoking,alcohol consumption,and their interactions with the risk of LBW.Meanwhile,stratified analysis was conducted to evaluate the stability of the associations.Results A total of 34104 singleton pregnancies and newborns were included in this study.Among these newborns,3020 cases were diagnosed with LBW,with an incidence of 8.9%(95%CI:8.6%-9.2%).The multivariate logistic regression analysis showed that maternal active smoking(OR=1.428,95%CI:1.147-1.777),passive smoking(OR=1.128,95%CI:1.031-1.235),and alcohol consumption(OR=2.297,95%CI:1.949-2.706)during periconceptional pregnancy were significantly associated with risk of LBW(all P<0.05).Additionally,the interaction analysis revealed an antagonistic effect between active smoking and alcohol consumption(OR=0.117,95%CI:0.049-0.278).Conclusions Maternal periconceptional active smoking,passive smoking,alcohol consumption and their interactions are significantly associated with neonatal LBW,highlighting the importance of maintaining healthy behaviors during pregnancy to prevent LBW.

关 键 词：低出生体重 吸烟 饮酒 交互作用 前瞻性队列研究 

分 类 号：R714[医药卫生—妇产科学]