南宁市武鸣区壮族人群小于胎龄儿的影响因素研究

目的了解壮族人群小于胎龄儿(small for gestational age,SGA)的流行情况,并探讨SGA的影响因素。方法选择2016年1月～2018年1月在南宁市武鸣区人民医院及武鸣区妇幼保健院产检并分娩的孕妇共3 839例,收集所有研究对象基本信息和相关研究因素的资料,采用随机森林算法、X^2检验和多因素Logistic回归对资料进行分析。结果武鸣区壮族人群SGA发生率为9. 6%(368/3 839),其中男婴的发生率为6. 9%(142/2 049),女婴的发生率为12. 6%(226/1 790)。随机森林显示孕中期胎儿宫内生长受限(intrauterine growth retardation,IUGR)的重要性评分最高,孕周最低,并筛选了7个最重要的变量纳入多因素Logistic回归。多因素分析显示,初产妇、孕妇身高<1. 55 m、孕期增重不足及孕中期IUGR是SGA的危险因素;孕前BMI≥18. 5 kg/m2及男婴则为SGA的保护因素。结论南宁市壮族人群SGA的发生率较高,且受多因素影响,应及时评估胎儿生长发育情况,采取综合措施以减少SGA的发生。

Analysis on potential factors of small for gestational age of Zhuang ethnicity in Wuming District of Nanning

  Objective  To understand the prevalence of small for gestational age (SGA) in Zhuang population, and to analyze the potential factors of SGA.  Methods  A total of 3 839 live births in the Wuming District People's Hospital and Wuming Maternal and Child Health Hospital from January 2016 to January 2018 were recruited. Random Forest, χ2 test and Logistic regression model were used for statistical analyses.  Results  The incidence of SGA was 9.6% (368/3 839), and it was 6.9% (142/2 049) and 12.6% (226/1 790) for male and female infants respectively. Random Forest method showed that second-trimester intrauterine growth restriction's importance score was the highest, but gestational week's was the lowest. Also, seven important variables were selected by this method. Unconditional logistic regression analysis showed that parity <2, the height of mothers <1.55 m, insufficient gestational weight gain, second-trimester intrauterine growth restriction were risk factors for SGA, but pre-pregnancy BMI ≥ 18.5 kg/m2 and male infants were protective factors.  Conclusions  The incidence of SGA is slightly higher, among the Zhuang population in Guangxi. SGA is affected by many factors. Therefore, it is necessary to evaluate the status of intrauterine growth and adopt comprehensive measures to control and reduce the incidence of SGA.