回顾性队列研究在职业因素与生殖结局分析中的应用  

The application of retrospective cohort study between vocational factor and pregnant outcome

作　　者：余清[1] 林莲莲[2] 王玉环[3] 陈素华[3] 张义喜[1] 卢园园[1] 黄阳[1] 

机构地区：[1]温州医学院预防医学教研室,浙江温州325027 [2]温州医学院第一附属医院产科,浙江温州325000 [3]温州医学院第二附属医院产科,浙江温州325027

出　　处：《温州医学院学报》2003年第6期383-385,共3页Journal of Wenzhou Medical College

摘　　要：目的 :研究职业因素对孕期生殖健康的影响。方法 :采用回顾性队列研究方法 ,对 14 0 5例产妇进行调查。经非条件logistic回归分析 ,调整孕妇年龄、文化程度、产检次数及吸烟等潜在混杂因素后 ,按职业类别对生殖结局进行多元分析。结果 :不同职业人群对孕期保健利用程度不同 ,低利用组别人群中农民、无固定职业者在早产、死产、低出生体重儿、产褥感染等方面的发生率显著高于平均水平。管理类人员的新生儿死亡、妊高征发病率高于平均水平 (OR值为 1.474,2 .773 )。专业技术人员低出生体重儿、胎儿宫内发育迟缓(IUGR)、死产的发生率较高 ,而文教职业对过期产、巨大儿、宫缩乏力的发生率有影响。职业在妊娠结局、妊娠并发症、新生儿状况等方面差异有显著性 ,并与妊高征间存在一定关联性 (rs=0 .0 68,P =0 .0 11)。结论Objective: To investigate the effect of vocational factor on reproduction health. Methods:1405 puerparae were investigated with retrospe ctive cohort study. The pregnant outcome was analyzed multiply according to occupatio nal class while unlimited logistic regression analysis was used to examine these associations and was adjusted by maternal age,educational situation,number of p renatal examination,smoking and latent confounding factors. Results:The person who used prenatal care less,especially farme rs and persons without stable occupation,had significantly high er rate in premature birth . Still birth,low birth weight(LBW)and puerperal infection because of different occ upation groups accessed to the prenatal care by different degree. Stillbirth and pregnancy-induced hypertension syndrome(PIH)were happened more than the aver ag e level in the group of management. Professionals and technicians suffered more from intrauterine growth retardation(IUGR)and PIH,while cultural and educational professionals had influential effect on overdue birth, fetal macrosomia and ute rine inertia. Occupational factor had distinctive influence on pregnancy outcome ,pregnancy complication and newborn baby,which also had relation to PIH (r s=0.068,P=0.011).Conclusion:The different occupational factor is one of main r isk factors in prenatal care and reproduction outcome.

关 键 词：回顾性队列研究 生殖健康 妊娠结局 偏倚 非务件logistic回归 

分 类 号：R195[医药卫生—卫生统计学] R173[医药卫生—卫生事业管理]