高危妊娠与产检次数对低出生体重的影响及其交互作用  

Independent and interaction effects of high-risk pregnancy and number of prenatal visits on low birth weight

作　　者：边艳霞 王莉[2,3,4] 李黄福[1] 义国宝 BIAN Yanxia;WANG Li;LI Huangfu;YI Guobao(Yangqu County Center for Disease Control and Prevention(Yangqu County health supervision Institute),Yangqu 030100,China;Department of pediatrics,School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Key Laboratory of Coal Environmental Pathogenicity and Prevention and Control,Ministry of Education,Taiyuan 030001,China;Early Childhood Health Development Research Center of Shanxi Medical University,Taiyuan 030001,China;Yangqu County Traditional Chinese Medicine Hospital,Yangqu 030100,China)

机构地区：[1]阳曲县疾病预防控制中心(阳曲县卫生监督所),阳曲030100 [2]山西医科大学公共卫生学院儿童少年卫生学教研室,太原030001 [3]煤炭环境致病与防治教育部重点实验室,太原030001 [4]山西医科大学早期儿童健康发展研究中心,太原030001 [5]阳曲县中医医院,阳曲030100

出　　处：《中华疾病控制杂志》2025年第1期22-26,54,共6页Chinese Journal of Disease Control & Prevention

基　　金：山西省自然科学基金(202103021224247)。

摘　　要：目的分析高危妊娠和产检次数对低出生体重的影响,并进一步探讨两者的交互作用。方法通过太原市妇幼保健综合管理平台收集2012年1月―2021年12月在阳曲县分娩的新生儿及其父母亲相关信息,采用logistic回归分析模型分析高危妊娠和产检次数交互作用与娩出低出生体重儿的关系。结果低出生体重儿的检出率为2.58%;控制混杂因素后,logistic回归分析模型分析结果显示:高危妊娠(OR=2.683,95%CI:1.791~4.019)、产检次数<5次(OR=2.802,95%CI:2.113~3.717)与低出生体重儿均呈正相关(均P<0.05);两者与娩出低出生体重儿存在相加交互作用[交互作用超额相对危险度(relative excess risk of interaction,RERI)=6.557,95%CI:1.007~12.107;归因交互效应百分比(attributable proportion of interaction,API)=0.652,95%CI:0.436~0.867;协同指数(synergy index,SI)=3.616,95%CI:1.708~7.654],高危妊娠和产检次数<5次同时存在的孕妇娩出低出生体重儿风险是两者均不存在的10.068倍(OR=10.068,95%CI:5.679~17.850)。结论高危妊娠和产检次数较少的相加交互作用增加孕妇娩出低出生体重儿的风险。在今后的妇幼保健工作中,应特别关注高危妊娠孕妇的产检次数和健康教育,降低娩出低出生体重儿的风险。Objective To explore the independent and interaction effects of high-risk pregnancy and number of prenatal visits on low birth weight(LBW).Methods Data pertaining to newborns who gave birth in Yangqu Country from January 2012 to December 2021 and their parents were collected through the Taiyuan Maternal and Child Health Comprehensive Management Platform.We used logistic regression model to analyze the independent and interaction effects.Results In this study,the detection rate of LBW was 2.58%.After controlling for confounding variables,logistic regression analysis implied that both high-risk pregnancy(OR=2.683,95%CI:1.791-4.019)and<5 times of prenatal visits(OR=2.802,95%CI:2.113-3.717)were positively associated with LBW(all P<0.05).The interaction between high-risk pregnancy and number of prenatal visits exhibited an additive effect on the likelihood of LBW(RERI=6.557,95%CI:1.007-12.107;API=0.652,95%CI:0.436-0.867;SI=3.616,95%CI:1.708-7.654).The risk of delivering an infant with LBW was 10.068 times greater when both high-risk pregnancy and<5 prenatal visits were present,compared to when neither of these factors was present(OR=10.068,95%CI:5.679-17.850).Conclusions The combined interaction of high-risk pregnancies and infrequent prenatal visits heightens the risk of delivering infants with LBW.It is advised that special attention be given to the number of prenatal visits and that health education tailored to expectant mothers with high-risk pregnancies be provided to reduce the incidence of low birth weight infants.

关 键 词：高危妊娠 产检 低出生体重 交互作用 

分 类 号：R181[医药卫生—流行病学] R174[医药卫生—公共卫生与预防医学]