The influencing factors in early pregnancy of term small for gestational age infant
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摘要:
目的 探究影响足月产小于胎龄儿(small for gestational age, SGA)发生的因素,为预防其发生提供科学依据。 方法 采用问卷调查及医院信息系统收集数据,使用logistic回归分析模型分析足月产SGA的影响因素。 结果 足月产SGA的发生率为6.6%,非初次怀孕、孕期补充二十二碳六烯酸(docosahexaenoic acid, DHA)是足月产SGA发生的保护因素,孕前低BMI、妊娠期合并脐带缠绕是足月产SGA发生的危险因素(均有P<0.05)。 结论 孕妇在备孕和妊娠期应保持合理体重、孕期补充DHA、预防脐带缠绕等妊娠期并发症,以降低SGA发生风险。 Abstract:Objective To explore the influencing factors of term small for gestational age (SGA) infant, and to provide a scientific basis for preventing the SGA. Methods Questionnaire survey and Hospital Information System (HIS) were used to collect data, and logistic regression analysis model was used to analyze the influencing factors of SGA. Results The incidence of SGA was 6.6%. Non-first pregnancy and docosahexaenoic acid (DHA) supplementation during pregnancy were the protective factors of SGA, low BMI before pregnancy and umbilical cord entanglement during pregnancy were the risk factors of SGA (all P < 0.05). Conclusion Pregnant women should maintain a reasonable weight before and during pregnancy, supplement DHA during pregnancy, and prevent umbilical cord entanglement and other pregnancy complications to reduce the risk of SGA. -
Key words:
- Term birth /
- Small for gestational age /
- Early pregnancy /
- Influencing factors
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表 1 研究对象一般人口学信息[n(%)]
Table 1. General demographic information of study subjects [n(%)]
变量 合计(N=4 919) SGA(n=389) AGA(n=4 530) Z/χ2值 P值 年龄(岁) -2.104 a 0.035 < 25 780(15.9) 72(18.5) 708(15.6) 25~<30 2 468(50.1) 202(51.9) 2 266(50.0) 30~<35 1 250(25.4) 86(22.1) 1 164(25.7) ≥35 421(8.6) 29(7.5) 392(8.7) 孕前BMI(kg/m2) -4.936 a < 0.001 < 18.5 704(14.3) 77(19.8) 627(13.8) 18.5~<24.0 3 192(64.9) 265(68.1) 2 927(64.6) 24.0~<28.0 803(16.3) 36(9.3) 767(16.9) ≥28.0 220(4.5) 11(2.8) 209(4.6) 民族 0.043 0.836 汉族 4 652(94.6) 367(94.3) 4 285(94.6) 少数民族 267(5.4) 22(5.7) 245(5.4) 户口 0.102 0.749 城镇 2 251(45.8) 175(45.0) 2 076(45.8) 农村 2 668(54.2) 214(55.0) 2 454(54.2) 生活地区 12.066 0.001 北方 2 565(52.1) 170(43.7) 2 395(52.9) 南方 2 354(47.9) 219(56.3) 2 135(47.1) 文化程度 -0.825 a 0.410 初中及以下 661(13.4) 48(12.3) 613(13.5) 高中 1 048(21.3) 76(19.5) 972(21.5) 本科 2 897(58.9) 244(62.7) 2 653(58.6) 硕士及以上 313(6.4) 21(5.4) 292(6.4) 家庭年收入(万元) 0.268 a 0.789 < 7 1 235(25.1) 85(21.9) 1 150(25.4) 7~<10 1 380(28.1) 127(32.6) 1 253(27.7) 10~<20 1 535(31.2) 130(33.4) 1 405(31.0) ≥20 769(15.6) 47(12.1) 722(15.9) 注:a使用的是Mann-Whitney U检验。 表 2 孕期相关信息的单因素分析结果[n(%)]
Table 2. Univariate analysis results of pregnancy-related information [n(%)]
变量 合计(N=4 919) SGA(n=389) AGA(n=4 530) χ2值 P值 孕次 16.547 < 0.001 初次 1 366(30.7) 140(40.3) 1 226(29.9) >1次 3 087(69.3) 207(59.7) 2 880(70.1) 产次 7.153 0.007 初次 2 487(56.3) 216(63.2) 2 271(55.7) >1次 1 933(43.7) 126(36.8) 1 807(44.3) 孕早期被动吸烟 5.323 0.021 否 2 790(56.7) 199(51.2) 2 591(57.2) 是 2 129(43.3) 190(48.8) 1 939(42.8) 补充叶酸 0.021 0.886 否 508(10.3) 41(10.5) 467(10.3) 是 4 411(89.7) 348(89.5) 4 063(89.7) 补充复合维生素 0.687 0.407 否 2 734(55.6) 224(57.6) 2 510(55.4) 是 2 185(44.4) 165(42.4) 2 020(44.6) 补充DHA 8.167 0.004 否 4 037(82.1) 340(87.4) 3 697(81.6) 是 882(17.9) 49(12.6) 833(18.4) 胎膜早破 2.546 0.111 否 4 253(86.5) 326(83.8) 3 927(86.7) 是 666(13.5) 63(16.2) 603(13.3) 脐带缠绕 6.391 0.011 否 4 419(89.8) 335(86.1) 4 084(90.2) 是 500(10.2) 54(13.9) 446(9.8) 妊娠期糖尿病 0.065 0.798 否 4 266(86.7) 339(87.1) 3 927(86.7) 是 653(13.3) 50(12.9) 603(13.3) 表 3 多因素logistic回归分析模型分析结果
Table 3. Multivariate logistic regression model analysis results
变量 β值 Wald值 OR(95% CI)值 P值 孕前BMI(kg/m2) < 18.5 0.714 4.564 2.042(1.061~3.931) 0.033 18.5~<24.0 0.486 2.350 1.626(0.873~3.029) 0.125 24.0~<28.0 -0.115 0.105 0.891(0.445~1.786) 0.746 ≥28.0 1.000 年龄(岁) < 25 1.000 25~<30 -0.091 0.390 0.913(0.686~1.215) 0.532 30~<35 -0.165 0.909 0.848(0.603~1.191) 0.340 ≥35 -0.070 0.084 0.933(0.581~1.496) 0.772 生活地区 北方 1.000 南方 0.250 5.226 1.284(1.036~1.592) 0.022 孕次 初次 1.000 >1次 -0.357 7.203 0.700(0.539~0.908) 0.007 产次 初次 1.000 >1次 -0.033 0.055 0.968(0.736~1.273) 0.815 孕早期被动吸烟 否 1.000 是 0.206 3.716 1.228(0.997~1.514) 0.054 补充DHA 否 1.000 是 -0.453 8.153 0.636(0.466~0.868) 0.004 脐带缠绕 否 1.000 是 0.338 4.610 1.402(1.030~1.908) 0.032 -
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