二胎妊娠并不会增加巨大儿的发生率：来自中国西部两个地区的横断面调查。
The second pregnancy has no effect in the incidence of macrosomia: a cross-sectional survey in two western Chinese regions.
机构信息
School of Public Health and Management, Chongqing Medical University, Chongqing, 400016, China.
Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, 400016, China.
出版信息
J Health Popul Nutr. 2021 Apr 13;40(1):19. doi: 10.1186/s41043-021-00244-z.
BACKGROUND
After the implementation of the universal two-child policy in China, the increase in parity has led to an increase in adverse pregnancy outcomes. The impact of one and two fetuses on the incidence of fetal macrosomia has not been fully confirmed in China. This study aimed to explore the differences in the incidence of fetal macrosomia in first and second pregnancies in Western China after the implementation of the universal two-child policy.
METHODS
A total of 1598 pregnant women from three hospitals were investigated by means of a cross-sectional study from August 2017 to January 2018. Participants were recruited by convenience and divided into first and second pregnancy groups. These groups included 1094 primiparas and 504 women giving birth to their second child. Univariate and multivariate logistic regression analyses were performed to discuss the differences in the incidence of fetal macrosomia in first and second pregnancies.
RESULTS
No significant difference was found in the incidence of macrosomia in the first pregnancy group (7.2%) and the second pregnancy group (7.1%). In the second-time pregnant mothers, no significant association was found between the macrosomia of the second child (5.5%) and that of the first child (4.7%). The multivariate logistic regression model showed that mothers older than 30 years are not likely to give birth to children with macrosomia (odds ratio (OR) 0.6, 95% confidence interval (CI) 0.4,0.9).
CONCLUSIONS
The incidence of macrosomia in Western China is might not be affected by the birth of the second child and is not increased by low parity.
背景
中国全面二孩政策实施后，生育二孩比例增加，导致不良妊娠结局增加。一孩和二孩对巨大儿发生率的影响在中国尚未得到充分证实。本研究旨在探讨中国西部全面二孩政策实施后，初产妇和经产妇二胎的巨大儿发生率的差异。
方法
采用横断面研究，于 2017 年 8 月至 2018 年 1 月，在 3 家医院调查了 1598 名孕妇。采用便利抽样法招募参与者，并分为初产妇组和经产妇组。初产妇组包括 1094 名初产妇和 504 名经产妇。采用单因素和多因素 logistic 回归分析探讨初产妇和经产妇二胎巨大儿发生率的差异。
结果
初产妇组巨大儿发生率（7.2%）与经产妇组（7.1%）无显著差异。经产妇中，第二胎巨大儿（5.5%）与第一胎巨大儿（4.7%）之间无显著关联。多因素 logistic 回归模型显示，年龄大于 30 岁的母亲不太可能生育巨大儿（比值比（OR）0.6，95%置信区间（CI）0.4，0.9）。
结论
中国西部巨大儿的发生率可能不受二孩出生的影响，低生育也不会增加巨大儿的发生率。
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