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[陕西省育龄妇女产前检查频次与双胎新生儿小于胎龄风险的关联]

[The association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age among neonatal twins in Shaanxi Province].

作者信息

Zhang B Y, Li M M, Liu A M, Wu W T, Guo H Y, Gao X Y, Wu C L, Shang S H, Yan H, Dang S N

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an 710061, China.

Department of Neurology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2020 Feb 6;54(2):129-132. doi: 10.3760/cma.j.issn.0253-9624.2020.02.003.

DOI:10.3760/cma.j.issn.0253-9624.2020.02.003
PMID:32074697
Abstract

To explore the association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age (SGA) among neonatal twins in Shaanxi Province. From July to December 2013, a total of 30 027 childbearing aged women, who were pregnant from January 2010 to November 2013 and had definite outcomes, were selected from 30 districts (counties) of Shaanxi Province by using the multi-stage random sampling method. The questionnaires with a face-to-face survey method were used to retrospectively collect demographic information, pregnancy history, lifestyle during pregnancy, disease history, nutritional supplements, and health care during pregnancy. Information on the gestational age and birth weight of the newborn were obtained by consulting the medical certificate of birth and were registered as twin A and twin B by birth order. Finally, 356 childbearing aged women and their twin babies with complete data were included in the analysis. A generalized estimation equation model was used to analyze the association between the frequency of prenatal care and the risk of SGA among neonatal twins. The age of childbearing aged women was (27.44±4.68) years old, of which 79.49% (283 women) were rural residents and 44.38% (158 women) had seven or more times prenatal care. The gestational age and birth weight were (37.64±2.51) weeks and (2 510±497) g, respectively. The prevalence of SGA was 51.40% (183/356) for twin A and 53.37% (190/356) for twin B, respectively. The prevalence of SGA was 44.30% (70/158) for twin A with seven or more times prenatal care and 42.41% (67/158) for twin B with seven or more times prenatal care, which was lower than that for twins with less than seven times prenatal care, respectively [57.07% (113/198) and 62.12% (123/198)] ( values were 0.017 and <0.001). The results of generalized estimation equation model suggested that compared to those with less than seven times prenatal care, after adjusting for parity, birth order, place of residence, maternal age, occupation, education, family wealth index, passive smoking, pregnancy-induced hypertension syndrome, folic acid, and iron supplement during perinatal period, and gender of the newborn, the (95) of risk of SGA among childbearing aged women with seven or more times prenatal care was 0.60 (0.40-0.91). Seven or more times prenatal care could reduce the risk of SGA among neonatal twins in Shanxi Province.

摘要

探讨陕西省育龄期妇女产前检查次数与双胎新生儿小于胎龄儿(SGA)风险之间的关联。2013年7月至12月,采用多阶段随机抽样方法,从陕西省30个区(县)选取2010年1月至2013年11月怀孕且结局明确的30027名育龄期妇女。采用问卷调查面对面访谈的方法,回顾性收集人口学信息、妊娠史、孕期生活方式、疾病史、营养补充剂及孕期保健情况。通过查阅出生医学证明获取新生儿的孕周和出生体重信息,并按出生顺序登记为双胞胎A和双胞胎B。最终,356名育龄期妇女及其双胞胎婴儿纳入分析,采用广义估计方程模型分析产前检查次数与双胎新生儿SGA风险之间的关联。育龄期妇女年龄为(27.44±4.68)岁,其中79.49%(283名)为农村居民,44.38%(158名)产前检查7次及以上。孕周和出生体重分别为(37.64±2.51)周和(2510±497)g。双胞胎A和双胞胎B的SGA患病率分别为51.40%(183/356)和53.37%(190/356)。产前检查7次及以上的双胞胎A和双胞胎B的SGA患病率分别为44.30%(70/158)和42.41%(67/158),低于产前检查次数少于7次的双胞胎[分别为57.07%(113/198)和62.12%(123/198)](P值分别为0.017和<0.001)。广义估计方程模型结果显示,与产前检查次数少于7次的妇女相比,在调整了产次、出生顺序、居住地、母亲年龄、职业、教育程度、家庭财富指数、被动吸烟、妊娠期高血压综合征、围产期叶酸和铁补充剂以及新生儿性别后,产前检查7次及以上的育龄期妇女SGA风险的(95)为0.60(0.40 - 0.91)。产前检查7次及以上可降低陕西省双胎新生儿SGA风险。

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