2013年至2022年北京市海淀区高龄产妇早产流行特征  

Analysis of preterm birth trends among advanced maternal-age women in Haidian District,Beijing from 2013 to 2022

作　　者：邹晓璇 李佳鑫 赵银珠 殷延敏 杨英 Zou Xiaoxuan;Li Jiaxin;Zhao Yinzhu;Yin Yanmin;Yang Ying(Department of Maternal and Child Health Information,Haidian District Maternal and Child Health Care Hospital,Beijing 100086,China;Human Genetic Resources Center,National Institute for Family Planning,Beijing 100081,China;Peking Union Medical College,Beijing 100730,China)

机构地区：[1]北京市海淀区妇幼保健院妇幼信息科,北京100086 [2]国家卫生健康委科学技术研究所人类遗传资源中心,北京100081 [3]北京协和医学院,北京100730

出　　处：《中华围产医学杂志》2025年第3期226-232,共7页Chinese Journal of Perinatal Medicine

摘　　要：目的分析2013年至2022年北京市海淀区高龄产妇早产流行趋势。方法回顾性分析2013年1月至2022年12月北京市海淀区出生登记数据中,分娩年龄≥35岁,且分娩孕周22~44周的产妇的记录。采用Joinpoint回归模型对海淀区高龄产妇早产率进行时间趋势分析。应用中断时间序列分析(interrupted time series,ITS)定量评价全面二孩政策对高龄产妇早产率的瞬时效应和长期影响。结果(1)最终纳入分析的出生登记数据共70640条,来自68587例产妇。其中2016年至2018年产妇人数达到高峰(分别为8158、9906和8914例)。现住北京人口比例由2013年的53.7%(2175/4049)逐步下降至2017年的42.0%(4160/9906),随后上升至2019年至2022年的98%以上[分别为98.8%(7828/7925)、99.1%(6283/6340)、99.3%(5970/6014)和99.5%(6371/6404)]。(2)68587例产妇中,57339例(83.6%)在三级分娩机构分娩,35496例(51.8%)剖宫产分娩。2017年至2022年多胎比例由2.4%(236/9906)缓慢增长至3.5%(225/6404)。2013年至2015年以初产妇为主,之后经产妇比例逐年上升,2018年达71.6%(6385/8914),之后逐年下降至2022年的56.2%(3600/6404)。(3)共分娩活产儿70640例。2017年分娩量最大,为10139例。2013年至2022年分娩男婴36995例和女婴33645例,不同性别早产率分别为10.6%(3914/36995)和9.4%(3123/33645)。(4)70640例中,其中超早产儿124例(0.2%),极早产儿773例(1.1%),晚期早产儿6140例(8.7%),分别占全部早产儿(7037例)的1.8%、11.0%和87.3%。(5)Joinpoint最优拟合结果显示,2013年至2017年早产率呈下降趋势(APC=-4.4%,95%CI:-13.0%~-0.2%),以2017年为分界点,2017年至2022年早产率呈上升趋势(APC=4.5%,95%CI:1.6%~13.0%)。(6)ITS分析结果显示,全面二孩政策生效当月早产率瞬时下降0.79%(β2=-0.79,P=0.026),政策生效后早产率平均每月上升0.03%(β3=0.07,P=0.001)。调整多胎比例后,早产率在全面二孩政策生效前明显下降(β1=-0.06,P=0.003),全面二孩政策生效后早产率平均每月上�ObjectiveTo analyze the trends of preterm birth among women of advanced maternal age in Haidian District,Beijing from 2013 to 2022.MethodsA retrospective analysis was conducted on the birth registration data in Haidian District,Beijing,from January 2013 to December 2022,focusing on the records of women aged≥35 who delivered between 22 and 44 weeks of gestation.The Joinpoint regression model was used to analyze the time trends of preterm birth rates among women of advanced maternal age in the Haidian District.Interrupted time series(ITS)analysis was applied to quantitatively evaluate the transient and long-term effects of China's universal two-child policy on the preterm birth rate among women of advanced maternal age.Results(1)A total of 70640 birth registration records from 68587 women were finally included.The number of women giving birth peaked between 2016 and 2018(8158,9906,and 8914 cases,respectively).The proportion of permanent residents in Beijing gradually decreased from 53.7%(2175/4049)in 2013 to 42.0%(4160/9906)in 2017 and then increased to over 98%between 2019 and 2022[98.8%(7828/7925),99.1%(6283/6340),99.3%(5970/6014),and 99.5%(6371/6404),respectively].(2)Among the 68587 women,57339(83.6%)were delivered at tertiary hospitals,and 35496(51.8%)were delivered by cesarean section.The proportion of multiple births increased slowly from 2.4%(236/9906)in 2017 to 3.5%(225/6404)in 2022.From 2013 to 2015,primiparous women accounted for the majority.Subsequently,the proportion of multiparous women increased annually,reaching 71.6%(6385/8914)in 2018 before gradually decreasing to 56.2%(3600/6404)in 2022.(3)A total of 70640 live births were delivered.The highest number of deliveries was in 2017,with 10139 cases.From 2013 to 2022,36995 male infants and 33645 female infants were born,with preterm birth rates of 10.6%(3914/36995)and 9.4%(3123/33645),respectively.(4)Among the 70640 infants,there were 124 extremely preterm infants(0.2%),773 very preterm infants(1.1%),and 6140 late preterm infants(8.7%),accounting for

关 键 词：高龄产妇 早产 趋势 Joinpoint回归 中断时间序列 

分 类 号：R714.21[医药卫生—妇产科学]