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[北京地区单胎巨大儿的发病率及其危险因素]

[Incidence of singleton macrosomia in Beijing and its risk factors].

作者信息

Ren J H, Wang C, Wei Y M, Yang H X

机构信息

Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2016 Jun 25;51(6):410-4. doi: 10.3760/cma.j.issn.0529-567X.2016.06.002.

DOI:10.3760/cma.j.issn.0529-567X.2016.06.002
PMID:27356474
Abstract

OBJECTIVE

To evaluate the prevalence of macrosomia in Beijing in 2013 and identify its risk factors.

METHODS

Retrospective six months analysis of 14 188 full-term singleton pregnant women from 15 hospitals with different levels in Beijing in 2013. Each participant's demographic data and medical information were collected individually by questionnaires. Multiple logistic regression analysis was used to examine the associations between variables and the risk of macrosomia.

RESULTS

(1)The total prevalence of macrosomia was 7.069% (1 003/14 188) in Beijing in 2013. (2)The prevalence varied between the 15 hospitals, the lowest was 5.36% (89/1 659), while the highest reached 8.80%(46/523). Furthermore, the incidence of macrosomia was 1.284 times (95% CI: 1.114- 1.480, P=0.001) higher in the second graded hospitals than that in the tertiary hospitals. (3) Multiple logistic regression analyses showed that risk factors for macrosomia were maternal height≥160 cm (adjusted OR=1.875, 95% CI: 1.559- 2.256), pre-pregnant body mass index (p-BMI) ≥24.0 kg/m(2) (24.0- 27.9 kg/m(2): adjusted OR=1.696, 95% CI: 1.426- 2.018; p-BMI≥28.0 kg/m(2): adjusted OR=2.393, 95% CI: 1.831- 3.127), gestational weight gain (GWG) ≥15.9 kg (adjusted OR=2.462, 95% CI: 2.125- 2.853), gravidity>1 (adjusted OR=1.408, 95% CI: 1.224- 1.620), gestational weeks≥40 (adjusted OR=2.007, 95%CI: 1.745-2.308) and gestational diabetes mellitus (adjusted OR=1.522, 95%CI: 1.298-1.784). GWG≥15.9 kg, p-BMI≥28.0 kg/m(2) and gestational weeks≥40 were three risk factors that had the strongest associations with macrosomia (all P<0.01).

CONCLUSIONS

The prevalence of macrosomia in hospitals with different levels is obvious different. Gestational weeks, p-BMI and GWG are three main controllable risk factors for macrosomia, thus should receive more attentions.

摘要

目的

评估2013年北京地区巨大儿的患病率并确定其危险因素。

方法

对2013年北京15家不同级别医院的14188名单胎足月孕妇进行为期6个月的回顾性分析。通过问卷调查分别收集每位参与者的人口统计学数据和医疗信息。采用多因素logistic回归分析来检验各变量与巨大儿风险之间的关联。

结果

(1)2013年北京地区巨大儿的总患病率为7.069%(1003/14188)。(2)15家医院的患病率有所不同,最低为5.36%(89/1659),最高达到8.80%(46/523)。此外,二级医院巨大儿的发生率比三级医院高1.284倍(95%CI:1.114 - 1.480,P = 0.001)。(3)多因素logistic回归分析显示,巨大儿的危险因素包括母亲身高≥160cm(调整OR = 1.875,95%CI:1.559 - 2.256)、孕前体重指数(p - BMI)≥24.0kg/m²(24.0 - 27.9kg/m²:调整OR = 1.696,95%CI:1.426 - 2.018;p - BMI≥28.0kg/m²:调整OR = 2.393,95%CI:1.831 - 3.127)、孕期体重增加(GWG)≥15.9kg(调整OR = 2.462,95%CI:2.125 - 2.853)、孕次>1(调整OR = 1.408,95%CI:1.224 - 1.620)、孕周≥40周(调整OR = 2.007,95%CI:1.745 - 2.308)以及妊娠期糖尿病(调整OR = 1.522,95%CI:1.298 - 1.784)。GWG≥15.9kg、p - BMI≥28.0kg/m²和孕周≥四十周是与巨大儿关联最强的三个危险因素(均P<0.01)。

结论

不同级别医院巨大儿的患病率存在明显差异。孕周、p - BMI和GWG是巨大儿的三个主要可控危险因素,因此应给予更多关注。

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