母亲孕前高肾小球滤过率与小体型脆弱儿的相关性分析  

Analysis of the correlation between the preconception increased estimated glomerular filtration rate of women and the risk of their small vulnerable newborns

作　　者：李慧敏 董婧 马旭 贺媛[1,2] LI Huimin;DONG Jing;MA Xu;HE Yuan(National Research Institute for Family Planning,Beijing,10008l;Chinese Academy of Medical Sciences&Peking Union Medical College)

机构地区：[1]国家卫生健康委科学技术研究所,北京100081 [2]北京协和医学院中国医学科学院

出　　处：《中国计划生育学杂志》2025年第4期763-769,共7页Chinese Journal of Family Planning

基　　金：国家重点研发计划(2016YFC1000102);中央高水平医院临床科研专项(2022-PUMCH-C-019)。

摘　　要：目的:探讨母亲孕前高肾小球滤过率(eGFR)与小体型脆弱儿的关联。方法:本研究为回顾性队列研究,基于2015年参加国家免费孕前健康检查项目(NFPHEP)的育龄女性进行分析。使用多因素logistic回归模型分析母亲孕前高eGFR与小体型脆弱儿的关联。采用限制性立方样条评估母亲孕前eGFR与小体型脆弱儿的剂量反应关系。通过亚组分析探讨影响母亲孕前eGFR与小体型脆弱儿关联的因素。结果:共纳入732906例研究对象,分娩小体型脆弱儿78091例,占10.7%。在调整一般人口学特征、生活习惯和健康状况后,以eGFR 90~120 ml/(min·1.73m^(2))水平为参照,孕前eGFR>120~150 ml/(min·1.73m^(2))及>150ml/(min·1.73m^(2))女性分娩小体型脆弱儿的风险有所增加(OR=1.06,95%CI 1.04~1.08;OR=1.14,95%CI 1.12~1.16)。母亲孕前eGFR与小体型脆弱儿发生风险之间存在非线性剂量反应关系。母亲户籍和文化程度与孕前eGFR水平存在交互效应(P_(交互效应)<0.05)。结论:孕前高eGFR可能是小体型脆弱儿的重要危险因素。Objective:To investigate the correlation between the preconception increased estimated glomerular filtration rate(eGFR)of women and the risk of their small vulnerable newborns.Methods:In this retrospective cohort study,analysis was conducted on Chinese childbearing-aged women participating in the National Free Preconception Health Examination Program(NFPHEP)in 2015.Multivariable logistic regression model was used to analyze the correlation between the preconception increased eGFR of the women and the risk of their small vulnerable newborns.The restricted cubic splines were used to examine the dose-response association between the preconception eGFR of the women and their small vulnerable newborn.Subgroup analyses were applied to explore the susceptibility factors influencing the association of the preconception eGFR of the women and their small vulnerable newborn.Results:In this study,a total of 732906 women were recruited,and 78091(10.7%)women with small vulnerable newborns were recorded.After adjusting the general demographic data,the lifestyle and the health status,compared with those of the women with the preconception eGFR level of 90-120ml/(min·1.73m^(2)),the women with the preconception eGFR level of>120-150 ml/(min·1.73m^(2))and the women with the preconception eGFR level>150 ml/(min·1.73m^(2))were associated with their increased risk of small vulnerable newborn(OR=1.06,95%CI 1.04-1.08;OR=1.14,95%CI 1.12-1.16).Non-linear dose-response relationship between the preconception eGFR level of the women and their small vulnerable newborn were identified.The residence and the educational level of the women were interaction effect with their preconception eGFR level(P of interaction effect<0.05).Conclusion:The increased preconception eGFR level of the women might be a significant risk factor of their small vulnerable newborns.

关 键 词：孕前肾小球滤过率 小体型脆弱儿 相关性分析 

分 类 号：R714.2[医药卫生—妇产科学]