北京市通州区2013 — 2017年低出生体重情况及危险因素分析

孟召学; 金楚瑶; 王海俊; 林力孜; 刘峥; 刘珏

doi:10.11847/zgggws1120587

北京市通州区2013 — 2017年低出生体重情况及危险因素分析

Incidence and risk factors of low birth weight in Tongzhou district of Beijing: 2013 – 2017

摘要

摘要:
目的了解北京市通州区2013 — 2017年低出生体重发生情况及危险因素，为减少低出生体重的发生提供依据。
方法收集2013 — 2017年单胎分娩孕妇的人口学资料、孕产史及妊娠情况，采用回顾性队列研究方法，分析低出生体重发生率以及不同因素对低出生体重发生率的影响，采用多因素logistic回归分析探索低出生体重的危险因素。
结果 2013 — 2017年通州区单胎孕妇低出生体重发生率为2.79 %，发生率随年份有上升趋势（χ²_趋势 = 3.99，P < 0.05），其中，极低出生体重儿占10.7 %；中度低出生体重发生率随年份有上升趋势（χ²_趋势 = 4.85，P < 0.05）。多因素回归显示，身高 < 160 cm（OR = 2.66，95 % CI = 1.71～4.12）、身高160～169 cm（OR = 1.63，95 % CI = 1.07～2.49）、失业或待业（OR = 1.22，95 % CI = 1.01～1.46）、初产妇（OR = 1.44，95 % CI = 1.20～1.74）、胎盘早剥（OR = 2.22，95 % CI = 1.32～3.72）、妊娠期高血压疾病（OR = 4.59，95 % CI = 3.64～5.78）、早产（OR = 69.69，95 % CI = 58.51～83.01）、女婴（OR = 1.34，95 % CI = 1.13～1.59）是低出生体重的危险因素。分层后多因素分析结果显示，母亲低身高、前置胎盘、胎盘早剥、胎膜早破、妊娠期高血压疾病是早产儿低出生体重的危险因素；而母亲低身高、初产、妊娠期高血压疾病、女婴是足月儿低出生体重的危险因素。
结论北京市通州区低出生体重发生率呈上升趋势，对于具有高危因素的孕妇应及早采取预防措施以减少低出生体重的发生。

Abstract:
Objective To explore the incidence and risk factors of low birth weight (LBW) among newborns in Tongzhou district of Beijing from 2013 to 2017 and to provide evidences for developing effective interventions to reduce LBW rate.
Methods The data on demographics, pregnancy history, and current pregnancy for all pregnant women with singleton births from 2013 to 2017 (n = 34 726) were collected from Hospital Information System of Tongzhou district and then analyzed retrospectively to explore the incidence and influence factors of low birth weight. Multivariate logistic regression analysis was used to analyze risk factors of LBW.
Results The incidence of LBW was 2.79% and increased significantly in the district during the 5-year period (χ²_trend = 3.99, P < 0.05). Of all the LBW neonates, 10.7% were very low birth weight and the proportion of moderate LBW increased significantly (χ²_trend = 4.85, P < 0.05). Multivariate regression analyses revealed following risk factors for LBW: maternal stature of less than 160 cm (odds ratio OR = 2.66, 95% confidence interval 95% CI: 1.71 – 4.12), maternal stature between 160 cm and 169 cm (OR = 1.63, 95% CI:1.07 – 2.49), maternal unemployment or underemployment (OR = 1.22, 95% CI: 1.01 – 1.46), being a primipara (OR = 1.44, 95% CI: 1.20 – 1.74), placenta previa (OR = 2.22, 95% CI: 1.32 – 3.72), hypertensive disorder complicating pregnancy (OR = 4.59, 95% CI: 3.64 – 5.78), preterm birth (OR = 69.69, 95% CI: 58.51 – 83.01), and with a female neonate (OR = 1.34, 95% CI: 1.13 – 1.59). Stratified multivariate analyses further confirmed that short maternal stature, placenta previa, placental abruption, premature rupture of membranes, and hypertensive disorder complicating pregnancy were risk factors of preterm LBW; while, short maternal stature, primipara, hypertensive disorder complicating pregnancy, and with a female neonate were risk factors of term LBW.
Conclusion The incidence of low birth weight increased obviously during 2013 to 2017 in Tongzhou district of Beijing. Early intervention on low birth weight should be conducted among the pregnant women at high risk to reduce the incidence of low birth weight.

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