南宁市武鸣区壮族人群小于胎龄儿的影响因素研究

秦小玲; 刘顺; 郭雪峰; 王能; 仇小强; 庞婷; 李柯桦; 刘美良; 伍柳玉; 曾小云

doi:10.16462/j.cnki.zhjbkz.2019.01.006

南宁市武鸣区壮族人群小于胎龄儿的影响因素研究

doi: 10.16462/j.cnki.zhjbkz.2019.01.006

1.
530021 南宁, 广西医科大学公共卫生学院流行病与卫生统计学教研室
2.
530199 南宁, 广西南宁市武鸣区人民医院超声科

基金项目:

国家自然科学基金项目 81460517

详细信息

通讯作者:
曾小云, E-mail: zxyxjw@21.cn.com

中图分类号: R181.2;R174.6
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- 文章访问数: 289
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- 被引次数: 0
出版历程
- 收稿日期: 2018-08-09
- 修回日期: 2018-11-01
- 刊出日期: 2019-01-10

Analysis on potential factors of small for gestational age of Zhuang ethnicity in Wuming District of Nanning

1.
Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China
2.
Department of Ultrasound, Wuming District People's Hospital, Nanning 530199, China

Funds:

National Natural Science Foundation of China 81460517

More Information

Corresponding author: ZENG Xiao-yun, E-mail: zxyxjw@21.cn.com

摘要

摘要: 目的了解壮族人群小于胎龄儿（small for gestational age，SGA）的流行情况，并探讨SGA的影响因素。方法选择2016年1月~2018年1月在南宁市武鸣区人民医院及武鸣区妇幼保健院产检并分娩的孕妇共3 839例，收集所有研究对象基本信息和相关研究因素的资料，采用随机森林算法、χ²检验和多因素Logistic回归对资料进行分析。结果武鸣区壮族人群SGA发生率为9.6%（368/3 839），其中男婴的发生率为6.9%（142/2 049），女婴的发生率为12.6%（226/1 790）。随机森林显示孕中期胎儿宫内生长受限（intrauterine growth retardation，IUGR）的重要性评分最高，孕周最低，并筛选了7个最重要的变量纳入多因素Logistic回归。多因素分析显示，初产妇、孕妇身高<1.55 m、孕期增重不足及孕中期IUGR是SGA的危险因素；孕前BMI ≥ 18.5 kg/m²及男婴则为SGA的保护因素。结论南宁市壮族人群SGA的发生率较高，且受多因素影响，应及时评估胎儿生长发育情况，采取综合措施以减少SGA的发生。
- 壮族 /
- 婴儿 /
- 小于胎龄 /
- 危险因素
Abstract: Objective To understand the prevalence of small for gestational age (SGA) in Zhuang population, and to analyze the potential factors of SGA. Methods A total of 3 839 live births in the Wuming District People's Hospital and Wuming Maternal and Child Health Hospital from January 2016 to January 2018 were recruited. Random Forest, χ² test and Logistic regression model were used for statistical analyses. Results The incidence of SGA was 9.6% (368/3 839), and it was 6.9% (142/2 049) and 12.6% (226/1 790) for male and female infants respectively. Random Forest method showed that second-trimester intrauterine growth restriction's importance score was the highest, but gestational week's was the lowest. Also, seven important variables were selected by this method. Unconditional logistic regression analysis showed that parity <2, the height of mothers <1.55 m, insufficient gestational weight gain, second-trimester intrauterine growth restriction were risk factors for SGA, but pre-pregnancy BMI ≥ 18.5 kg/m² and male infants were protective factors. Conclusions The incidence of SGA is slightly higher, among the Zhuang population in Guangxi. SGA is affected by many factors. Therefore, it is necessary to evaluate the status of intrauterine growth and adopt comprehensive measures to control and reduce the incidence of SGA.
- Zhuang nationality /
- Infant /
- Small for gestational age /
- Risk factors

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图 1 随机森林分类错误率

Figure 1. Error rates of classification

下载: 全尺寸图片幻灯片

图 2 变量重要性评分

Figure 2. The importance scores of factors

下载: 全尺寸图片幻灯片

表 1 1武鸣区壮族孕妇基本特征[n(%)]

Table 1. Characteristics of pregnant women of Zhuang ethnicity in Wuming district [n(%)]

基本特征	SGA	非SGA	χ²值	P值
年龄(岁)			0.035	0.851
＜35	296(9.5)	2 806(90.5)
≥35	72(9.8)	665(90.2)
户籍			0.278	0.598
农村	335(9.7)	3 130(90.3)
城镇	33(8.8)	341(91.2)
产次			17.519	＜0.001
初产	145(12.6)	1 003(87.4)
经产	223(8.3)	2 468(91.7)
流产史			5.579	0.018
有	170(8.5)	1 828(91.5)
无	198(10.8)	1 643(89.2)
是否服用叶酸			1.791	0.181
是	226(10.1)	2 006(89.9)
否	142(8.8)	1 465(91.2)
孕妇身高(m)			17.206	＜0.001
≥1.55	223(8.3)	2 465(91.7)
＜1.55	145(12.6)	1 006(87.4)
孕期增重不足			12.619	＜0.001
否	253(8.6)	2 674(91.4)
是	115(12.6)	797(87.4)
孕前BMI(kg/m²)			17.244	＜0.001
＜18.5	70(14.9)	401(85.1)
≥18.5	298(8.8)	3 070(91.2)
孕早期Hb(g/L)			3.626	0.057
≥110	281(9.1)	2 795(90.9)
＜110	87(11.4)	676(88.6)
是否孕中期IUGR			61.371	＜0.001
否	275(8.2)	3 086(91.8)
是	93(19.5)	385(80.5)
产期Hb(g/L)			0.171	0.679
≥110	290(9.5)	2 767(90.5)
＜110	78(10.0)	704(90)
孕周(周)			0.178	0.673
≥37	360(9.6)	3 383(90.4)
＜37	8(8.3)	88(91.7)
新生儿性别			35.758	＜0.001
男	142(6.9)	1 907(93.1)
女	226(12.6)	1 564(87.4)

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表 2 壮族人群SGA多因素Logistic回归分析

Table 2. Multivariate logistic regression analysis of risk factors for SGA of Zhuang population

变量	β	Wald值	P值	OR(95% CI)值
产次
经产				1.00
初产	0.484	16.889	＜0.001	1.62(1.29~2.04)
孕妇身高(m)
≥1.55				1.00
＜1.55	0.452	15.174	＜0.001	1.57(1.25~1.97)
孕期增重不足
否				1.00
是	0.497	18.967	＜0.001	1.64(1.31~2.06)
孕前BMI(kg/m²)
＜18.51.00
≥18.5	-0.480	10.423	0.001	0.62(0.46~0.83)
是否孕中期IUGR
否				1.00
是	0.913	45.949	＜0.001	2.49(1.91~3.24)
新生儿性别
女				1.00
男	-0.606	28.048	＜0.001	0.55(0.44~0.68)

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