Bian Yihua, Zhang Zhan, Liu Qiao, Wu Di, Wang Shoulin
State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210029, China; ; Department of Reproductive Health Care, Wuxi Maternal and Child Health Hospital Affilaited to Nanjing Medical University, Wuxi, Jiangsu 214002, China.
J Biomed Res. 2013 Jan;27(1):14-22. doi: 10.7555/JBR.27.20120046. Epub 2012 Dec 15.
Low birth weight (LBW) is an important risk factor for neonatal and infant mortality and morbidity in adults.. However, no large scale study on the prevalence of LBW and related maternal risk factors in China has been published. To explore the effects of maternal factors on LBW for term birth in China, we conducted a hospital-based retrospective study of 55, 633 Chinese pregnancy cases between 2001 and 2008. Maternal sociodemographic data, history of infertility and contraceptive use were obtained. Their medical status and diseases during pre-pregnancy were examined by physical examination at the first antenatal care visit. Maternal medical status before childbirth and pregnancy outcomes, including body weight, infant gender, multiple pregnancy and congenital anomalies, were recorded. Univariate and multivariate logistic regression, and linear regression were used to investigate the relationship between maternal factors and term LBW. The general incidence of term LBW was 1.70% in the developed area of China. After preliminary analysis using the univariate model, low primary education, anemia, hypertensive disorders, placental previa, oligohydramnios and premature rupture of membrane were predicted as independent factors of term LBW in the multivariate model. Furthermore, the decrease in annual frquencies of these risk factors were major causes of gradual decline in the incidence of LBW (from 2.43% in 2001 to 1.21% in 2008). The study demonstrated that among maternal factors, primary education, anemia and hypertensive disorders could contribute to LBW for term birth even in the most developed area of China.
低出生体重是新生儿及成年期婴儿死亡和发病的重要危险因素。然而，中国尚未发表关于低出生体重患病率及相关孕产妇危险因素的大规模研究。为探究中国孕产妇因素对足月出生低出生体重的影响，我们对2001年至2008年间55633例中国妊娠病例进行了一项基于医院的回顾性研究。获取了孕产妇的社会人口学数据、不孕史和避孕使用情况。在首次产前检查时通过体格检查评估她们孕前的健康状况和疾病。记录孕产妇分娩前的健康状况和妊娠结局，包括体重、婴儿性别、多胎妊娠和先天性异常。采用单因素和多因素逻辑回归以及线性回归来研究孕产妇因素与足月低出生体重之间的关系。中国发达地区足月低出生体重的总体发生率为1.70%。在使用单因素模型进行初步分析后，小学低学历、贫血、高血压疾病、前置胎盘、羊水过少和胎膜早破在多因素模型中被预测为足月低出生体重的独立因素。此外，这些危险因素年发生率的下降是低出生体重发生率逐渐下降（从2001年的2.43%降至2008年的1.21%）的主要原因。该研究表明，在孕产妇因素中，即使在中国最发达的地区，小学低学历、贫血和高血压疾病也可能导致足月出生低出生体重。
