足月产小于胎龄儿的孕早期影响因素

吕天琛; 曲翌敏; 湛永乐; 陈云利; 石英杰; 岳和欣; 赵健; 江宇

doi:10.16462/j.cnki.zhjbkz.2022.09.003

足月产小于胎龄儿的孕早期影响因素

doi: 10.16462/j.cnki.zhjbkz.2022.09.003

1.
100730 北京，中国医学科学院北京协和医学院群医学及公共卫生学院流行病与生物统计学系
2.
999077 香港，香港大学李嘉诚医学院公共卫生学院
3.
100020 北京，中国医学科学院北京协和医学院医学信息研究所
4.
100021 北京，中国医学科学院北京协和医学院医学实验动物研究所
5.
100730 北京，中国医学科学院北京协和医学院群医学及公共卫生学院营养与食品安全学系

基金项目:

中国医学科学院医学与健康科技创新工程 2019-I2M-2-007

详细信息

通讯作者:
江宇，E-mail: jiangyu@pumc.edu.cn

中图分类号: R715.3
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出版历程
- 收稿日期: 2022-02-23
- 修回日期: 2022-05-20
- 网络出版日期: 2022-09-17
- 刊出日期: 2022-09-10

The influencing factors in early pregnancy of term small for gestational age infant

1.
Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
2.
School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
3.
Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100020, China
4.
Institute of Laboratory Animals Science, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
5.
Department of Nutrition and Food Safety, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Funds:

CAMS Innovation Fund for Medical Sciences 2019-I2M-2-007

More Information

Corresponding author: JIANG Yu, E-mail: jiangyu@pumc.edu.cn

摘要

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。
- 足月产 /
- 小于胎龄儿 /
- 孕早期 /
- 影响因素
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.
- 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。

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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)

下载: 导出CSV

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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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。

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足月产小于胎龄儿的孕早期影响因素

doi: 10.16462/j.cnki.zhjbkz.2022.09.003

通讯作者:
江宇，E-mail: jiangyu@pumc.edu.cn

计量

The influencing factors in early pregnancy of term small for gestational age infant

Corresponding author: JIANG Yu, E-mail: jiangyu@pumc.edu.cn

计量

目录

留言板

足月产小于胎龄儿的孕早期影响因素

doi: 10.16462/j.cnki.zhjbkz.2022.09.003

通讯作者: 江宇，E-mail: jiangyu@pumc.edu.cn

计量

出版历程

The influencing factors in early pregnancy of term small for gestational age infant

Corresponding author: JIANG Yu, E-mail: jiangyu@pumc.edu.cn

计量

出版历程

目录

通讯作者:
江宇，E-mail: jiangyu@pumc.edu.cn