妊娠期产前检查次数与低出生体重儿的相关性

廖芳; 田美玲; 王朔; 石子佳; 袁会卿; 王莉

doi:10.16462/j.cnki.zhjbkz.2021.10.019

妊娠期产前检查次数与低出生体重儿的相关性

doi: 10.16462/j.cnki.zhjbkz.2021.10.019

廖芳^{1, 2},
田美玲²,
王朔^{1, 2},
石子佳^{2, 3},
袁会卿^{2, 3},
王莉^{2, 4, ,}

1.
063210 唐山，华北理工大学研究生院
2.
050051 石家庄，河北省人民医院妇产科
3.
050017 石家庄，河北医科大学研究生院
4.
519000 珠海，中山大学附属第五医院妇产科

基金项目:

河北省科技厅重点项目 18397779D

河北省科技厅引智项目 2019YX013A

详细信息

通讯作者:
王莉，E-mail: wangli719@126.com

中图分类号: R181;R174
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-01
- 修回日期: 2021-01-28
- 网络出版日期: 2021-11-17
- 刊出日期: 2021-10-10

A study on the relationship between the number of prenatal visits and low birth weight infants

LIAO Fang^{1, 2},
TIAN Mei-ling²,
WANG Shuo^{1, 2},
SHI Zi-jia^{2, 3},
YUAN Hui-qing^{2, 3},
WANG Li^{2, 4
, ,}

1.
Graduate School of North China University of Science and Technology, Tangshan 063210, China
2.
Department of Obstetrics and Gynecology, Hebei Provincial People's Hospital, Shijiazhuang 050051, China
3.
Graduate School of Hebei Medical University, Shijiazhuang 050017, China
4.
Department of Obstetrics and Gynecology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai 519000, China

Funds:

Key Project of Hebei Provincial Department of Science and Technology 18397779D

Project of Introduction of Hebei Provincial Department of Science and Technology 2019YX013A

More Information

Corresponding author: WANG Li, E-mail: wangli719@126.com

摘要

摘要: 目的了解河北省孕产妇产前检查状况，探讨产前检查次数与低出生体重儿的关系。方法对2013年1月1日―2017年12月31日河北省22所监测医院入院的分娩≥28周、年龄在18~≤55周岁的263 171例单胎孕产妇及其新生儿资料进行分析，根据孕产妇产前检查次数将其分为0~≤3次、4~≤7次及≥8次三组，分析孕产妇产前检查次数与低出生体重儿的关系。结果随着产前检查次数的增加，低出生体重儿的发生率有降低的趋势。多因素Logistic回归分析模型显示，产前检查次数0~≤3次的孕产妇低出生体重儿发生率是≥8次孕产妇的1.802倍；产前检查次数4~≤7次孕产妇低出生体重儿发生率是≥8次孕产妇的1.268倍。多因素Logistic回归分析模型显示，孕妇高龄、产次多及终止妊娠孕周小是产前检查次数的独立危险因素，孕妇受教育程度高、妊娠次数多及合并妊娠合并症是产前检查次数的保护因素。结论产前检查次数越多，发生低出生体重儿的风险越低，应加强对受教育程度低、产次多及高龄等孕妇的健康教育和产前保健，减少低出生体重儿的发生。
- 孕妇 /
- 产前保健 /
- 早产 /
- 低出生体重儿 /
- 相关
Abstract: Objective To understand the prenatal healthcare examination status of pregnant women in Hebei Province, and to explore the relationship between the frequency of prenatal visits and low birth weight infants. Methods The data of 263 171 singleton pregnant women aged 18-≤55 and their newborns who were delivered for more or equal to 28 weeks and were hospitalized in 22 monitoring hospitals in Hebei Province, from January 2013 to December 2017 were analyzed.They were divided into three groups based on the number of prenatal visits, including 0-≤3, 4-≤7 and≥8. The relationship between the number of prenatal visits and low birth weight children was analyzed. Results With the increase in the number of prenatal visits, the prevalance of low birth weight infants tend to decrease. Multivariate Logistic regression analysis showed that the incidence of low birth weight infants in pregnant women with 0-≤3 prenatal visits was 1.802 times that of pregnant women who had equal to or more than 8 prenatal visits comparatively; The incidence of low birth weight infants in pregnant women with 4-≤7 prenatal visits was 1.268 times than that of pregnant women with more or equal to 8 prenatal visits. Multivariate Logistic regression analysis showed that the advanced age of pregnant women, multiple births and small gestational age were the independent risk factors for the number of prenatal visits.The high educational level of pregnant women, the number of pregnancies and pregnancy complications were the protective factors for the number of prenatal visits. Conclusions The more the frequency of prenatal visits, the lower the risk of low birth weight infants.Hence we should strengthen the health education and prenatal care for pregnant women with low educational level, multiple childbirths and advanced age, so as to promote the health of mothers and infants.
- Pregnant women /
- Antenatal care /
- Preterm birth /
- Low birth weight infants /
- Relationship

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图 1 河北省2013―2017年孕产妇新生儿资料数据筛选流程图

Figure 1. Flowchart of data screening for maternal and neonatal data from 2013 to 2017 in Hebei Province

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表 1 2013―2017年河北省不同人口学及产科学特征孕产妇产前检查次数的差异分析[n(%)]

Table 1. Analysis on the difference of prenatal visits of pregnant women with different demographic and obstetric characteristics from 2013 to 2017 in Hebei Province [n(%)]

变量	产前检查次数(次)			χ²值	P值
变量	0~≤3	4~≤7	≥8	χ²值	P值
年龄(岁)				238.076	＜0.001
18~＜35	14 857(6.6)	126 358(55.8)	85 187(37.6)
35~≤55	2 134(9.2)	12 748(55.0)	8 289(35.8)
受教育程度				16 985.355	＜0.001
文盲及小学	1 152(22.7)	3 034(59.9)	883(17.4)
初中及高中	12 377(7.6)	103 695(62.8)	48 331(29.6)
大学及以上	3 462(4.3)	33 377(41.2)	44 262(54.6)
婚姻状况				41.666	＜0.001
单身/离异/丧偶	48(6.9)	337(48.6)	309(44.5)
已婚	16 905(6.8)	138 585(55.8)	93 087(37.4)
同居	38(12.6)	184(60.9)	80(26.5)
妊娠次数(次)				1 318.786	＜0.001
1	6 059(5.9)	54 072(52.6)	42 748(41.6)
≥2	10 932(7.5)	85 034(58.0)	50 728(34.6)
产次(次)				3 713.603	＜0.001
0	6 983(5.5)	64 683(51.3)	54 411(43.1)
≥1	10 008(8.1)	74 423(60.3)	39 065(31.6)
既往剖宫产次(次)				1 041.852	＜0.001
0	13 000(6.6)	106 083(54.3)	76 449(39.1)
≥1	3 991(7.4)	33 023(61.1)	17 027(31.5)
新生儿性别				6.005	0.050
男	8 807(6.9)	71 644(55.9)	47 730(37.2)
女	8 184(6.7)	67 462(55.6)	45 746(37.6)
新生儿体重(g)				995.101	＜0.001
＜2 500	1 205(13.8)	5 229(59.8)	2 307(26.4)
2 500~＜4 000	14 406(6.6)	121 532(55.7)	82 301(37.7)
≥4 000	1 380(6.1)	12 345(54.6)	8 868(39.3)
终止妊娠方式				65.993	＜0.001
阴道分娩	8 466(7.0)	66 040(54.9)	45 717(38.0)
剖宫产	8 525(6.6)	73 066(56.5)	47 759(36.9)
孕妇有无合并症				284.223	＜0.001
有	5 689(6.1)	51 440(54.7)	36 886(39.2)
无	11 302(7.3)	87 789(56.4)	56 630(36.4)

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表 2 2013―2017年河北省低出生体重儿与产前检查次数的Logistic回归分析模型

Table 2. Logistic regression analysis model of low birth weight infants and the times of prenatal visits from 2013 to 2017 in Hebei Province

变量	产前检查次数0~≤3次			产前检查次数4~≤7次
变量	β值	OR(95% CI)值	P值	β值	OR(95% CI)值	P值
校正前	1.104	3.017(2.808~3.241)	＜0.001	0.589	1.544(1.469~1.622)	＜0.001
校正后	0.434	1.802(1.646~1.973)	＜0.001	0.238	1.268(1.196~1.345)	＜0.001
注：产前检查次数≥8次组OR值为1.000；校正因素包括年龄、受教育程度、婚姻状况、妊娠次数、产次、既往剖宫产次、终止妊娠孕周及有无并发症。

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表 3 2013―2017年河北省产前检查次数影响因素的多因素Logistic回归分析模型分析

Table 3. Multivariate Logistic regression analysis on influencing factors of prenatal visits from 2013 to 2017 in Hebei Province

变量	产前检查次数0~≤3次			产前检查次数4~≤7次
变量	β值	OR(95% CI)值	P值	β值	OR(95% CI)值	P值
年龄(岁)
18~＜35		1.000		1.000
35~≤55	0.188	1.206(1.143~1.274)	＜0.001	-0.068	0.934(0.906~0.964)	＜0.001
受教育程度
文盲及小学		1.000		1.000
初中及高中	-1.526	0.217(0.198~0.238)	＜0.001	-0.446	0.640(0.593~0.691)	＜0.001
大学及以上	-2.631	0.072(0.065~0.079)	＜0.001	-1.420	0.242(0.224~0.261)	＜0.001
婚姻状况
已婚		1.000		1.000
单身/离异/丧偶	-0.031	0.969(0.710~1.324)	0.845	-0.174	0.841(0.716~0.987)	0.034
同居	0.736	2.088(1.408~3.098)	＜0.001	0.223	1.253(0.960~1.636)	0.097
妊娠次数(次)
1		1.000		1.000
≥2	-0.326	0.722(0.679~0.766)	＜0.001	-0.181	0.834(0.812~0.857)	＜0.001
产次(次)
0		1.000		1.000
≥1	0.740	2.095(1.970~2.229)	＜0.001	0.413	1.512(1.468~1.557)	＜0.001
既往剖宫产次(次)
0		1.000		1.000
≥1	-0.086	0.917(0.876~0.960)	＜0.001	0.065	1.067(1.041~1.095)	＜0.001
终止妊娠孕周(周)
37~≤41⁺⁶		1.000		1.000
28~≤36⁺⁶	1.227	3.411(3.198~3.639)	＜0.001	0.545	1.725(1.651~1.803)	＜0.001
≥42	0.839	2.314(1.915~2.796)	＜0.001	0.293	1.340(1.174~1.529)	＜0.001
合并症
无		1.000		1.000
有	-0.329	0.917(0.876~0.960)	＜0.001	-0.137	0.872(0.857~0.888)	＜0.001

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