江苏省昆山市孕产妇孕期体重变化与胎儿出生体重关系的流行病学分析

目的 探讨孕期体重变化与胎儿出生体重之间的关联.方法 以2001-2009年江苏省昆山市围产保健监测系统登记的33 631名孕产妇与单胎活产新生儿为研究对象,排除母亲孕前糖尿病和及其他因素,以产检期内体重变化为研究变量,按照初次产检时BMI进行分层,以此探究孕期体重变化与胎儿出生体重之间关联.孕期周体重(kg)变化=(末次产检体重-初次产检体重)/(末次产检孕周-初次产检孕周).结果 昆山市在2001-2009年的9年间低出生体重平均发生率为1.86％;而巨大胎儿发生率则相对较高(8.47％).以初次产检BMI进行分层,调整潜在的混杂因素后,无序多分类logistic回归分析表明,在体重偏低组,第三、四分位水平的孕期体重变化可减少低出生体重( ＜2500 g)胎儿发生风险;在体重正常组,第二、三、四分位水平的孕期体重变化可减少低出生体重胎儿发生风险,体重偏低及正常组其第四分位现患比值比(POR及其95％CI分别为0.51(0.32 ～0.80)和0.58(0.42 ～ 0.79);趋势检验显示,随着孕期增重变化水平增加,低出生体重胎儿发生风险在逐渐降低.对巨大胎儿(≥4000 g),产妇不论是偏瘦还是肥胖,高水平的孕期体重变化均可增加巨大胎儿发生风险.体重偏低、正常、超重及肥胖组其第四分位体重变化水平的POR值(95％CI)分别为4.69(2.82 ～ 7.81)、4.15(3.43～5.03)、3.64(2.62～ 5.06)和1.96(1.48 ～ 2.60);随着孕期体重变化水平增加,分娩巨大胎儿风险亦逐渐增加.结论 在偏瘦及体重正常组的孕妇,随着孕期体重变化水平增加,分娩低出生体重胎儿风险逐渐减小;不论产妇是偏瘦还是肥胖,随着孕期体重的增加,巨大胎儿发生风险则逐渐增加.     

江苏省昆山市孕产妇孕期体重变化与胎儿出生体重关系的流行病学分析

目的 探讨孕期体重变化与胎儿出生体重之间的关联.方法 以2001-2009年江苏省昆山市围产保健监测系统登记的33 631名孕产妇与单胎活产新生儿为研究对象,排除母亲孕前糖尿病和及其他因素,以产检期内体重变化为研究变量,按照初次产检时BMI进行分层,以此探究孕期体重变化与胎儿出生体重之间关联.孕期周体重(kg)变化=(末次产检体重-初次产检体重)/(末次产检孕周-初次产检孕周).结果 昆山市在2001-2009年的9年间低出生体重平均发生率为1.86％;而巨大胎儿发生率则相对较高(8.47％).以初次产检BMI进行分层,调整潜在的混杂因素后,无序多分类logistic回归分析表明,在体重偏低组,第三、四分位水平的孕期体重变化可减少低出生体重( ＜2500 g)胎儿发生风险;在体重正常组,第二、三、四分位水平的孕期体重变化可减少低出生体重胎儿发生风险,体重偏低及正常组其第四分位现患比值比(POR及其95％CI分别为0.51(0.32 ～0.80)和0.58(0.42 ～ 0.79);趋势检验显示,随着孕期增重变化水平增加,低出生体重胎儿发生风险在逐渐降低.对巨大胎儿(≥4000 g),产妇不论是偏瘦还是肥胖,高水平的孕期体重变化均可增加巨大胎儿发生风险.体重偏低、正常、超重及肥胖组其第四分位体重变化水平的POR值(95％CI)分别为4.69(2.82 ～ 7.81)、4.15(3.43～5.03)、3.64(2.62～ 5.06)和1.96(1.48 ～ 2.60);随着孕期体重变化水平增加,分娩巨大胎儿风险亦逐渐增加.结论 在偏瘦及体重正常组的孕妇,随着孕期体重变化水平增加,分娩低出生体重胎儿风险逐渐减小;不论产妇是偏瘦还是肥胖,随着孕期体重的增加,巨大胎儿发生风险则逐渐增加.     

孕前体质指数及孕期增重对新生儿出生体重影响的前瞻性队列研究

  目的   分析孕妇孕前体质指数(body mass index, BMI)及孕期增重(gestational weight gain, GWG)与新生儿出生体重的关联性, 并探究孕妇孕前及孕中体重动态变化对新生儿低出生体重(low birth weight, LBW)及巨大儿的影响。   方法   收集中国孕产妇队列·协和纳入的孕早期孕妇孕前体重, 并随访至分娩后, 收集分娩前体重及新生儿出生结局。将孕妇孕前BMI分为低体重组、正常体重组及超重/肥胖组, 将GWG分为适宜、不足及过多组。采用多因素多分类(多项)Logistic回归分析模型探讨孕前BMI及GWG与新生儿出生体重的关系。   结果   孕前BMI及GWG与子代出生体重相关(均有P < 0.05)。孕前超重/肥胖(OR=2.339, 95% CI:1.674~2.282, P < 0.001)、GWG过多(OR=1.398, 95% CI:1.188~1.978, P=0.048)显示为巨大儿的危险因素, GWG不足(OR=1.479, 95% CI:1.461~1.679, P=0.035)显示为LBW的危险因素, GWG过多会降低LBW的发生风险(OR=0.428, 95% CI:0.225~0.817, P=0.010)。低BMI-GWG不足(OR=1.335, 95% CI:1.048~2.319, P=0.048)是LBW的危险因素; 正常BMI-GWG过多(OR=1.088, 95% CI:1.016~1.675, P=0.038)和超重/肥胖-GWG过多(OR=1.498, 95% CI:1.244~2.017, P=0.046)是巨大儿的危险因素。   结论   孕前BMI及GWG是影响新生儿出生体重的重要因素, 提示女性应合理控制孕前及孕中体重变化。     

孕期体重增长与出生体重关系研究

目的探讨上海地区产妇孕期体重增长的适宜范围及其与出生体重之间的关系。方法收集上海交通大学医学院附属仁济医院产科和上海市长宁区妇幼保健院产科分娩的自然妊娠、单胎、足月产产妇资料。采集孕妇自身指标(年龄、孕周、文化程度、身高、孕前体重、分娩前体重、受孕方式、产次、既往疾病史)和胎儿指标(出生孕周、分娩方式、胎儿性别、出生体重、出生身长)。体质指数(body mass index,BMI)=体重(kg)/身高(m)2。孕妇妊娠前BMI≥24.0 kg/m2为超重,18.4 kg/m2为低体重。足月分娩胎儿出生体重4 000 g为巨大儿。结果共收集1 103人产妇纳入本研究(低体重组192人、正常体重组761人、超重组150人)。巨大儿总发生率为6.3%。随着产妇年龄的增加,BMI也逐步升高。低体重组和正常体重组孕期体重增长明显高于超重组产妇,前两组之间无明显差异低体重组(15.4±4.3)kg、正常体重组(15.5±5.1)kg、超重组(13.0±6.0)kg;虽然超重组产妇体重增长较少,但胎儿出生体重却明显高于其他2组产妇低体重组(3 261.2±341.9)g、正常体重组(3 387.9±383.7)g、超重组(3 469.6±408.2)g。低体重组孕妇自然分娩率最高(57.8%),其次为正常体重组(48.6%),超重组最低(40.0%)。采用四分位数方法,孕前低体重组和正常体重组的孕期体重适宜增长范围为12.0~18.5 kg,超重组则为9.0~16.0 kg。二项Logistic回归分析显示孕前BMI和孕期体重增长是巨大儿发生的危险因素。结论孕前BMI和孕期体重增长是巨大儿发生的危险因素。控制孕前BMI和孕期体重增长才能有效降低巨大儿的发生。     

沈阳市3～6岁幼儿出生体重与目前超重及肥胖关系的调查

目的了解沈阳市3～6岁幼儿超重及肥胖情况,并调查出生体重与幼儿期肥胖发生的关系。方法采取整群抽样的方法,对沈阳市5所幼儿园3～6岁幼儿进行问卷调查及体格检查。结果1707名幼儿中超重及肥胖幼儿检出率分别为16.17%和7.15%。女童超重及肥胖检出率明显高于男童（P〈0.01）;出生体重正常者占89.63%,低出生体重者占1.86%,巨大儿占8.51%。与出生体重正常者比较,巨大儿在幼儿期超重及肥胖的发生率明显增高,差异有统计学意义（P〈0.05）,但低出生体重与幼儿期超重和肥胖的发生没有相关关系。结论巨大儿是幼儿期超重及肥胖发生的危险因素,预防肥胖应该从胎儿期抓起。     

二孩政策后影响闵行区巨大儿发生的危险因素分析*

摘 要 目的 分析二孩政策后影响闵行区巨大儿发生的危险因素。方法 采用回顾性整群抽样的方法,收集2016-2019年闵行区产检并分娩的单胎足月新生儿27221例。分析产妇孕前体重指数(BMI)、孕期增重、产次、年龄、户籍、妊娠期糖尿病、新生儿性别等因素对巨大儿发生的影响。结果 孕前超重肥胖组巨大儿发生风险(13.9％)是孕前标准体重组(7.0％)的2.0倍(OR=2.0);孕期增重过多组巨大儿发生风险(11.9％)是孕期增重适宜组(5.4％)的2.2倍(OR=2.2)。年龄与新生儿性别对巨大儿发生率的影响有统计学差异。结论 二孩政策后孕前超重肥胖和孕期体重增长过多是巨大儿发生的主要因素,高龄也是引起巨大儿的危险因素之一。     

不同出生体重儿体格发育水平与营养状况的出生队列研究

[目的]了解不同出生体重儿婴幼儿期身长、体重和体质指数（body mass index,BMI）的动态变化及营养不良、超重和肥胖的发生率.[方法]对2 547名婴幼儿0～30个月的体检资料进行统计分析,计算BMI值并采用身高别体重中位数百分比法来判定营养不良、超重和肥胖.[结果]在0～30月中,巨大儿在各年龄的体重、身长和BMI均为3组之最,其次为正常出生体重儿,低出生体重儿处于最低水平.不同出生体重儿的超重和肥胖发生率在出生后头3个月呈上升趋势,于3个月时达到高峰.巨大儿组在出生后各年龄段的营养不良发生率在三组中处于最低水平,低出生体重儿组营养不良发生率在出生后第3年有明显上升趋势.[结论]宫内生长与儿童早期生长有密切的关系,在重视预防婴幼儿超重和肥胖的同时也要加强营养不良的预防.     

孕前体重指数、孕期增重与妊娠结局的关系

目的通过分析浦口区产妇孕前体重指数、孕期体重增长与妊娠结局的关系,开展孕期保健指导。方法收集并回收浦口区《江苏省围产保健手册》,统计孕前体重、孕前体重指数等孕妇自身指标;统计出生体重、出生孕周等胎儿指标;记录妊娠期糖尿病、妊娠期高血压、巨大儿产后出血、剖宫产发生率。分析孕妇消瘦组(BMI18.4 kg/m~2)、正常组(18.5kg/m~2≤BMI23.9 kg/m~2)、肥胖组(BMI≥24 kg/m~2)与妊娠期糖尿病、高血压、高血脂、产后出血、巨大儿发病关系。计数资料比较采用χ~2检验,P0.05为差异有统计学意义。结果统计产妇资料399份,消瘦组45例,正常组292例,肥胖组62例;孕妇肥胖组高血压、糖尿病、高血脂、巨大儿发生率均高于消瘦组和正常组(均P0.05),低体重组的孕妇年龄低于肥胖组。结论做好孕期保健指导,控制孕前体重增长可有效降低妊高症、糖尿病和巨大儿的发生,降低剖宫产率。     

母亲孕前体质指数及孕期增重与新生儿出生体重的关系

目的探讨母亲孕前体质指数(BMI)、孕期增重与新生儿出生体重的关系。方法回顾性调查2013年10月1日—2014年9月30日期间分娩的宁海户籍产妇4 197人,根据孕前BMI分为低体重组、正常体重组、超重组和肥胖组,分析各组孕期体重增长幅度、新生儿出生体重及与分娩方式的关系。结果 4 197名孕妇孕期平均增重(14.38±4.14)kg,新生儿平均出生体重(3 253±412)g,巨大儿发生率6.58%。随着母亲孕前BMI增加,新生儿平均出生体重增加,巨大儿发生率增加(P均0.05)。不同BMI孕妇孕期平均增重不同,低体重组增加最多,肥胖组增加较少,各组比较差异有统计学意义(P0.05)。结论孕前肥胖与孕期增重过多增加巨大儿的风险。     

江苏地区4～7岁儿童肥胖和超重与出生体重关系的研究

目的 了解江苏省4～7岁儿童肥胖和超重与出生体重之间的关系,为预防和减少儿童期肥胖提供科学依据.方法 对江苏省覆盖13个市区20 488名儿童进行体格检查,并结合孕妇妊娠结局卡资料分析儿童超重、肥胖与出生体重的关系.结果 随着出生体重的幅度增加儿童肥胖和超重的发生与出生体重的发生比例呈上升趋势;低出生体重组（LBW〈2 500 g）、正常出生体重组（NBW=2 500～3 999 g）和高出生体重组（HBW≥4 000 g）肥胖和超重的发生比例分别为13.0%、20.5%和55.1%.结论 新生儿的出生体重对儿童发生超重和肥胖影响显著,应从母亲怀孕期间就开始预防儿童期肥胖和超重,避免高体重儿童出生.     

贫困农村地区低出生体重影响因素病例对照研究

目的:了解贫困农村地区低出生体重发生率,分析其影响因素,为制定适宜的干预策略和措施提供科学依据。方法:2007年1～12月对云南省农村某贫困地区出生体重进行监测,并对其中170例低体重儿进行1∶2病例对照研究,采用单因素、多因素Logistic回归模型分析低出生体重影响因素。结果:①低出生体重发生率为7.97%,以宫内发育迟缓为主(67.84%)。②多因素Logistic逐步回归分析结果显示孕前一年患慢性病、孕期患慢性疾病和分娩地点为乡村医院、孕期有明显妊娠反应、孕期增重≤6.9kg、早产史是发生低出生体重的危险因素。③身高、孕期产检次数≥5次、婴儿胎龄足是低出生体重发生的保护因素。结论:祥云县贫困农村LBW发生率高于全国和全省平均水平。母亲孕前、孕期健康状况、孕期保健和营养状况是该地区低出生体重的主要影响因素。加强贫困农村地区的保健工作,开展适宜的孕期营养干预是减少低出生体重的重要保障。     

Determinants of low birth weight among HIV-infected pregnant women in Tanzania.

BACKGROUND: Low birth weight (LBW) increases the risk of infant death, but little is known about its causes among HIV-infected populations in sub-Saharan Africa. OBJECTIVE: We assessed sociodemographic, nutritional, immunologic, parasitic, and infant risk factors for birth weight, LBW, and small-for-gestational-age (SGA) status in a cohort of 822 HIV-positive women enrolled in a clinical trial of vitamin supplementation and pregnancy outcomes in Dar es Salaam, Tanzania. DESIGN: Women were enrolled at prenatal care clinics during their second trimester, at which time blood, stool, urine, and genital specimens were collected, and anthropometric measurements and sociodemographic data were recorded. Birth weight was measured at hospital delivery. RESULTS: The mean (+/-SD) birth weight was 3015 +/- 508 g, 11.1% of newborns weighed <2500 g (LBW), and 11.5% were SGA. In multivariate analyses, maternal weight at enrollment and a low CD8 cell count were inversely associated with LBW. Advanced-stage HIV disease, previous history of preterm birth, Plasmodium falciparum malaria, and any helmintic infection were associated with higher risk of LBW. The intestinal parasites Entamoeba histolytica and Strongyloides stercoralis were predictors of LBW despite their low prevalence in the cohort. In a multivariate-adjusted linear regression model, BMI, midupper arm circumference, a CD4 cell count <200 x 10(6) cells/L (200 cells/mm(3)), primiparity, maternal literacy, and infant HIV infection at birth were significantly associated with birth weight in addition to risk factors included in the LBW model. Determinants of SGA included maternal weight, low serum vitamin E concentration, candidiasis, malaria, and infant HIV infection at birth. CONCLUSION: Prevention of HIV disease progression and vertical transmission, improved nutritional status, and better management of malaria and intestinal parasitic infections are likely to reduce the incidence of LBW in Tanzania.     

Effects of wildfire disaster exposure on male birth weight in an Australian population

Background and objectives: Maternal stress can depress birth weight and gestational age, with potential health effects. A growing number of studies examine the effect of maternal stress caused by environmental disasters on birth outcomes. These changes may indicate an adaptive response. In this study, we examine the effects of maternal exposure to wildfire on birth weight and gestational age, hypothesising that maternal stress will negatively influence these measures.Methodology: Using data from the Australian Capital Territory, we employed Analysis of Variance to examine the influence of the 2003 Canberra wildfires on the weight of babies born to mothers resident in fire-affected regions, while considering the role of other factors.Results: We found that male infants born in the most severely fire-affected area had significantly higher average birth weights than their less exposed peers and were also heavier than males born in the same areas in non-fire years. Higher average weights were attributable to an increase in the number of macrosomic infants. There was no significant effect on the weight of female infants or on gestational age for either sex.Conclusions and implications: Our findings indicate heightened environmental responsivity in the male cohort. We find that elevated maternal stress acted to accelerate the growth of male fetuses, potentially through an elevation of maternal blood glucose levels. Like previous studies, our work finds effects of disaster exposure and suggests that fetal growth patterns respond to maternal signals. However, the direction of the change in birth weight is opposite to that of many earlier studies.     

子宫内膜厚度对冻融胚胎移植胎儿出生体质量的影响

目的探讨冻融胚胎移植日子宫内膜厚度与胎儿出生体质量的关系。方法选取2016年6月至2018年12月期间于郑州大学第三附属医院生殖医学中心行冻融胚胎移植的1622个单胎活产周期进行回顾性队列分析,根据移植日子宫内膜厚度分为4组,A组:子宫内膜厚度≤8 mm;B组:子宫内膜厚度8~10 mm;C组:子宫内膜厚度10~12 mm;D组:子宫内膜厚度≥12 mm。比较各组患者的一般资料及临床数据,以A组为参照组,控制混杂因素,计算其他各组低出生体质量(low birth weight,LBW)、极低出生体质量(very low birth weight,VLBW)、足月LBW、小于胎龄儿(small for gestational age,SGA)、早产的优势比(odds ratio,OR)及95%置信区间(95%CI),并采用多元线性回归分析影响胎儿出生体质量的相关因素。结果4组胎儿的出生体质量依次为(3350.15±568.17)g、(3431.84±523.43)g、(3445.93±483.73)g、(3482.27±495.30)g,组间比较差异均无统计学意义(P>0.05)。经多因素逻辑回归分析校正混杂因素后,A组的早产风险大于C组(OR=0.527,95%CI=0.287~0.968,P=0.039),移植日子宫内膜厚度不影响LBW、VLBW、足月LBW、SGA发生率(P均>0.05)。多元线性回归分析显示体质量指数(body mass index,BMI)、移植胚胎阶段、分娩孕周、新生儿性别均会影响胎儿出生体质量(P<0.001,P=0.003,P<0.001,P<0.001)。结论在冻融胚胎移植周期中,移植日子宫内膜厚度≤8 mm的妇女发生早产的可能性比内膜厚度10~12 mm的妇女高,但子宫内膜厚度不影响胎儿出生体质量。     

Is Maternal Smoking during Early Pregnancy a Risk Factor for All Low Birth Weight Infants?

Background

Low birth weight (LBW) infants do not form a homogeneous group; LBW can be caused by prematurity or poor fetal growth manifesting as small for gestational age (SGA) infants or intrauterine growth retardation. We aimed to clarify the relationship of maternal smoking with both SGA and preterm LBW infants.

Methods

The study population comprised pregnant women who registered at the Koshu City between January 1, 1995, and December 31, 2000, and their children. We performed multivariate analyses using multiple logistic regression models to clarify the relationship of maternal smoking during pregnancy with the SGA outcome and preterm birth in LBW infants.

Results

In this study period, 1,329 pregnant women responded to questionnaires, and infant data were collected from 1,100 mothers (follow-up rate: 82.8%). The number of LBW infants was 81 (7.4%). In this cohort, maternal smoking during early pregnancy was associated with LBW and the SGA outcome. Maternal smoking during early pregnancy was a risk factor for LBW with SGA outcome and for LBW with full-term birth. However, it was not a risk factor for LBW with appropriate weight for gestational age (AGA) and LBW with preterm birth.

Conclusion

These results suggested that LBW with AGA and LBW with preterm birth were associated with other risk factors that were not considered in this study, such as periodontal disease. For the prevention of LBW, not only abstinence from smoking during pregnancy but also other methods such as establishing a clinical setting should be adopted.Key words: Infant, Low Birth Weight; Pregnancy; Risk Factors; Smoking     

Effect of type and timing of oil supplements to sows during pregnancy on the growth performance and endocrine profile of low and normal birth weight offspring

Eighty-eight multiparous sows were used to evaluate whether type and timing of oil supplementation during gestation influences the incidence of low birth weight (LBW). Sows were allocated (eight per treatment) commercial sow pellets (3 kg/d; control diet) or an experimental diet consisting of control diet plus 10 % extra energy in the form of excess pellets, palm oil, olive oil (OO), sunflower oil (SO) or fish oil; experimental diets were fed during either the first half (G1) or second half (G2) of gestation. Growth performance and endocrine profile of LBW (<1.09 kg) and normal birth weight (NBW; 1.46-1.64 kg) offspring were compared. Maternal dietary supplementation altered the distribution curve for piglet birth weight. SOG1 sows had a greater proportion of LBW piglets (P<0.05), whilst it was reduced in the OOG1 group (P<0.05). Growth rate of LBW piglets was lower compared with their NBW siblings (P<0.05) when dietary supplementation was offered in G2 but were similar for G1. At birth, LBW offspring of supplemented animals possessed more fat compared with the control group (P<0.05); LBW offspring of control animals exhibited a more rapid decline in fat free mass/kg prior to weaning. Plasma metabolites and insulin concentrations were influenced by maternal diet and birth weight. In conclusion, maternal dietary supplementation altered the distribution of piglet birth weights and improved the energy status of LBW piglets. Supplementation with MUFA during G1 reduced the incidence of LBW, whereas PUFA had the reverse effect.     

Social determinants of infant mortality in a historical Swedish cohort

Background: Infant mortality rates have fallen considerably in the past decades. However, because of sparseness of historical data, it is unclear how social differences in infant mortality have changed over time. Methods: The aim of this study was to assess the association between prenatal social determinants and infant mortality in a Swedish cohort of 13 741 singletons born between 1915 and 1929. Associations and potential mediation of these determinants through other maternal and birth factors were studied using Cox regression. Analyses were repeated for deaths within the neonatal and post‐neonatal periods. Results: Mother's single marital status, high parity, low birthweight (LBW), low gestational age and male sex were associated with infant mortality in fully adjusted models, whereas the associations of maternal social class, region of residence and maternal age appeared to be largely mediated through other variables. Contrary to studies reporting a ‘LBW paradox’, no interactions between gestational age or birthweight and maternal social characteristics on infant mortality were observed in this study. High maternal age, LBW and low/high gestational age were associated with neonatal mortality, whereas single marital status, high parity, LBW, low gestational age and male sex were associated with post‐neonatal mortality. An association of family social class with post‐neonatal mortality was largely mediated by other maternal variables. Conclusions: Our findings of determinants of neonatal and post‐neonatal mortality in 1915–1929 are strikingly consistent with results from contemporary cohorts. On the other hand, contrary to most recent findings, there is no evidence of a LBW paradox in this historical cohort.     

Adverse birth outcomes in United Republic of Tanzania--impact and prevention of maternal risk factors

OBJECTIVE: To determine risk factors for poor birth outcome and their population attributable fractions. METHODS: 1688 women who attended for antenatal care were recruited into a prospective study of the effectiveness of syphilis screening and treatment. All women were screened and treated for syphilis and other reproductive tract infections (RTIs) during pregnancy and followed to delivery to measure the incidence of stillbirth, intrauterine growth retardation (IUGR), low birth weight (LBW) and preterm live birth. FINDINGS: At delivery, 2.7% of 1536 women experienced a stillbirth, 12% of live births were preterm and 8% were LBW. Stillbirth was independently associated with a past history of stillbirth, short maternal stature and anaemia. LBW was associated with short maternal stature, ethnicity, occupation, gravidity and maternal malaria whereas preterm birth was associated with occupation, age of sexual debut, untreated bacterial vaginosis and maternal malaria. IUGR was associated with gravidity, maternal malaria, short stature, and delivering a female infant. In the women who had been screened and treated for syphilis, in between 20 and 34% of women with each outcome was estimated to be attributable to malaria, and 63% of stillbirths were estimated as being attributable to maternal anaemia. Screening and treatment of RTIs was effective and no association was seen between treated RTIs and adverse pregnancy outcomes. CONCLUSION: Maternal malaria and anaemia continue to be significant causes of adverse pregnancy outcome in sub-Saharan Africa. Providing reproductive health services that include treatment of RTIs and prevention of malaria and maternal anaemia to reduce adverse birth outcomes remains a priority.     

Weight loss during pregnancy is associated with adverse pregnancy outcomes among HIV-1 infected women

In a prospective study of 1002 pregnant, HIV-1 infected Tanzanian women, we examined the incidence of fetal death, preterm delivery, low birth weight (LBW), and small for gestational age (SGA) births in relation to maternal anthropometry at the first prenatal visit, weight loss, and low weight gain during pregnancy. Anthropometric measurements were obtained monthly during the 2nd and 3rd trimesters. Low maternal height and weight at the first visit were significantly related to lower mean birth weight and increased risk of SGA, but not to preterm delivery. Maternal stature < 150 cm was significantly related to fetal death. Weight loss during pregnancy, defined as a negative slope of the regression of weight measurements on the week of gestation, occurred in 10% of the women. It was related to increased relative risk (RR) of fetal death (RR = 1.83, 95% CI = 0.93, 3.57), preterm delivery (RR = 1.85, 95% CI = 1.40, 2.44), and LBW (RR = 2.85, 95% CI = 1.69, 4.79) after adjusting for multivitamin supplementation, height, primiparity, baseline weight, malaria, CD4 cell count, HIV disease stage, and intestinal parasitoses. The significant association with fetal death was stronger for weight loss during the 2nd trimester, whereas increased risks of preterm delivery and LBW were higher for weight loss during the 3rd. Similar but weaker associations were found with low weight gain during pregnancy (slope < 25th percentile). We conclude that poor anthropometric status at the first prenatal visit and weight loss during pregnancy among HIV-1 infected women are strong risk factors for adverse pregnancy outcomes.     

2009~2013年浦东新区不同户籍人群出生人口特征分析

目的:分析上海市浦东新区不同户籍人群出生人口特征,为进一步完善浦东新区妇幼卫生管理和疾病预防控制政策提供参考依据,提高出生人口素质。方法:利用出生医学信息登记系统的监测数据,分析对比浦东新区流动入口与户籍人口的出生特征。结果:流动人口出生男女性别比为119.67,剖宫产率为43.87%。流动人口巨大儿率(7.93%)低出生体重率(3.23%),均高于户籍人口(6.48%、2.37%),流动人口出生缺陷报告率(10.51‰)高于户籍人口(9.89‰)。结论:应加强外来流动人口的男女平等观念及优生优育健康教育,并为他们提供可及性高的妇幼保健和卫生资源。