农村低出生体重儿危险因素的病例对照研究

采用流行病学回顾性配对调查方法,对1992～1994年澄江县农村236名低出生体重儿和 236名正常出生体重儿进行了病例—对照研究,对 31个因素同时采用单因素的卡方检验和多因素的Logistic分析进行研究,结果表明3年农村低出生体重儿平均发生率为4.15％,经单因素分析两组在母亲文化程度、身高、体重、孕次、产次、第一次产检孕周、产检次数、分娩孕周、经济收入、高危因素、臀位、双胎、过期妊娠、怀孕期间情绪、怀孕期间饮食、早产史16个方面差异有显著性(P<0.05);经Logistic分析选出的低出生体重儿的主要危险因素为母亲文化程度、怀孕期间情绪、身高、体重、孕次、产次、双胎、臀位、分娩孕周、经济收入、第一次产检孕周、民族、年龄、地区、新生儿性别。     

低出生体重儿发生率及危险因素分析

目的:了解新疆伊犁州妇幼保健院2005～2006年的低出生体重儿发生率及其影响因素。方法:对2005～2006年伊犁州妇幼保健院1993例住院分娩资料进行分析。结果:①低出生体重儿发生率为6.9%;②低出生体重单因素分析:母亲民族、产次是否超过3次、新生儿性别、是否足月、双胎、有否妊娠合并症/并发症、胎儿窘迫在低出生体重上的差异具有统计学意义;③多因素Logistic逐步回归分析结果显示母亲民族、新生儿性别、是否足月、双胎是发生低出生体重的危险因素。结论:少数民族孕妇的营养和保健需要予以特别的重视。     

围产保健对降低低出生体重的影响

目的探讨低出生体重与母亲孕产期等因素的关系。方法对１９９３～１９９６年嘉兴市秀城区９３３７例活产儿（２６９例低出生体重儿）的围产保健资料进行收集、整理、统计、分析。结果４年中低出生体重儿（＜２５００ｇ）的平均发生率为２．８８％，有逐年下降趋势。低出生体重儿与母亲的文化、身高、妊娠胎数、产前检查次数、分娩孕周以及胎儿性别有关。结论做好围产保健、孕产妇系统管理，有利于降低低出生体重儿的发生率、围产儿死亡率和婴儿死亡率     

中国活产出生体重的影响因素

【目的】　根据 1998年中国活产儿出生体重调查数据 ,分析影响出生体重的各种因素。　【方法】　采用分层抽样方法 ,对 1998年 7～ 10月期间在抽样地区出生的孕周≥ 2 8周的活产儿进行出生体重测查。同时调查抽样地区育龄妇女贫血率 ,收集海拔高度、1998年人均国民生产总值等数据。　【结果】　不同胎龄活产儿出生体重一般是男性高于女性 ,但在孕 2 9周和 31周时女性出生体重略高于男性。不论男女 ,在孕 4 2周以后胎儿体重已经停止增长并出现下降趋势。孕 32周后男女活产儿出生体重随胎龄增长的趋势一致 ,并分别于孕 34周和孕 37周出现 2次增重高峰。出生体重受产次影响 ,第 4产或更高产次活产儿的出生体重明显下降。出生体重随海拔高度升高而明显下降 ,海拔高度每升高 10 0m ,出生体重下降 6 .1g。随海拔高度的升高 ,宫内发育迟缓儿的发生率和占低出生体重儿的比例均显著升高。低出生体重发生率随同地区育龄妇女贫血率增加而显著升高 (χ2 =81.4 ,P <0 .0 0 1)。年人均国民生产总值 2 0 0 0元以下地区活产儿的出生体重显著低于 2 0 0 0元以上地区 ,相差达 12 0g。　【结论】　本次调查发现 ,男女胎儿体重增长有 2个高峰 ,分别出现在孕 34和 37周。平均出生体重与同一地区的海拔高度、育龄妇女贫血率和     

2015年厦门市异常出生体质量儿发生情况调查及相关因素分析

目的调查厦门市活产新生儿中异常出生体质量发生情况,分析相关因素。方法以2015年厦门市全部助产机构分娩的活产新生儿及其母亲为研究对象,分析低出生体质量儿和巨大儿的相关影响因素。结果 2015年厦门市助产机构共分娩活产儿83 811名,体质量正常儿76 195名(占90. 91%)、低出生体质量儿4 035名(占4. 81%)、巨大儿3 581名(占4. 27%),平均出生体质量为(3 222. 27±461. 64) g,男婴和女婴平均出生体质量比较差异有统计学意义(P<0. 05);平均出生身长为(49. 78±1. 88) cm,男婴和女婴平均出生身长比较差异有统计学意义(P<0. 05)。Logistic多因素回归分析显示母亲年龄、婴儿性别、胎数、孕次、产次与低出生体质量儿发生相关;而母亲年龄、婴儿性别、孕次与巨大儿发生相关。结论厦门市低出生体质量儿发生率接近全国平均水平,巨大儿发生率低于全国平均水平,母亲年龄、婴儿性别、胎数、孕次、产次是异常体质量儿发生的相关因素。     

低出生体重儿的影响因素研究

目的:应用描述性研究的方法,找出低体重儿的危险因素,为避免低体重儿的发生即优生优育提供可靠的理论依据。方法:符合纳入和排除标准的5842例确立为分析和研究的对象。结果:①通过低出生体重儿的影响因素单因素非条件Logistic回归分析发现:产次、孕次、孕周、产前空腹血糖、产前血压、季节、脐带长度有统计学意义(P<0.05),其中产次、孕次、孕周(37～40周)、产前血压是危险因素;秋季、脐带长度(30～70cm)是保护因素。②影响低出生体重儿的计量资料分析,通过成组t检验发现:产妇的产前体重、产妇的身高、胎盘重量有统计学意义,都对低出生体重儿有影响。③通过低体重儿多因素非条件Logistic回归结果发现:孕周、产前血压、秋季有统计学意义(P<0.05),其中孕周、秋季是保护因素,可避免低出生体重儿的发生;产前血压是危险因素,易导致低出生体重儿的发生。结论:孕妇的身高、体重、胎盘重量、孕次、产次、秋季是低出生体重儿的影响因素,其中孕周、秋季、产前空腹血糖、脐带长度是低出生体重儿的保护因素;产前血压是低出生体重儿的危险因素。     

4144例单胎活产儿出生体重相关影响因素分析

目的:探讨新生儿出生体重的相关影响因素。方法:选取唐山市人民医院2001年1月1日~2004年12月31日出生的4 144例单胎活产新生儿,对其出生体重的相关影响因素进行分析。结果:不同性别的新生儿平均出生体重比较有极显著性差异(P<0.01),不同文化程度的产妇其新生儿平均出生体重比较也有极显著性差异(P<0.01),不同孕次的产妇新生儿出生体重比较有显著性差异(P<0.05),不同产次的新生儿平均出生体重比较无显著性差异(P>0.05),在本研究中未发现产妇年龄以及产前血红蛋白含量和新生儿出生体重有相关关系。结论:本次调查发现,产妇的文化程度、孕次、新生儿性别是新生儿出生体重的影响因素。     

活产新生儿出生体重影响因素调查分析

目的 探讨活产新生儿出生体重影响因素。方法 对2000-2005年6345例活产新生儿出生体重影响因素进行跟踪调查。结果 母亲身高、孕周、胎数、分娩方式、孕期情况等是影响新生儿出生体重的主要因素。结论 活产新生儿出生体重受多种因素的影响。     

广西平果县和德保县壮族人群低出生体重的影响因素研究

目的 分析壮族人群低出生体重发生情况,探讨低出生体重儿的影响因素。方法 选取在广西平果县人民医院、妇幼保健院及德保县妇幼保健院2012年1月1日~2015年6月1日出生的4 915例壮族活产新生儿为研究对象,收集一般人口学资料及低出生体重相关的影响因素,采用多因素Logistic回归方法分析低出生体重儿的影响因素。结果 低出生体重儿358例,低出生体重率为7.28%。母亲孕龄≥35岁（OR=1.72）、身高150 cm以下（OR=2.75）、孕早期体质指数（body mass index,BMI）<18.5 kg/m2（OR=1.68）、血红蛋白浓度<110 g/L（OR=1.50）、孕中期增重少（OR=1.57）、流产史（OR=1.76）、妊娠期高压（OR =5.32）、多产次（OR=1.51）、孕期产前检查少于8次（OR=2.10）等为低出生体重儿发生的危险因素;母亲孕早期BMI≥24.0 kg/m2（OR=0.26）、分娩孕周37周及以上（OR =0.06）、单胎（OR=0.04）等为保护因素。结论 母亲孕龄、身高、孕早期BMI、血红蛋白浓度、流产史、妊娠期高血压、孕期产前检查次数等是壮族人群低出生体重的影响因素,应采取综合措施预防和减少低出生体重儿的发生。     

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.     

Blood pressure in relation to birth weight in twins and singleton controls matched for gestational age

Associations between adult blood pressure and birth weight were investigated in 122 same-sex twin pairs aged 18-50 years and 86 singleton controls matched according to maternal age and parity, gender, gestational age, and current age who were recruited via an obstetric database in Aberdeen, Scotland, in 1999. Twins weighed on average 425 g less than controls at birth (p < 0.001) but did not differ significantly in adult height or systolic or diastolic blood pressure from the controls. Among controls, the differences in systolic and diastolic blood pressure per kg of difference in birth weight, adjusted for gender, gestational age, current age, body mass index, smoking, physical activity level, and alcohol intake, were -4.3 (95% confidence interval (CI): -12.8, 4.3) and -6.1 (95% CI: -10.8, -1.5) mmHg/kg, respectively. In unpaired analysis among all twins, the equivalent values were -0.1 (95% CI: -4.0, 3.8) mmHg/kg for systolic pressure and -0.4 (95% CI: -2.9, 2.2) mmHg/kg for diastolic pressure, while in within-pair analysis the values were -0.9 (95% CI: -6.4, 4.6) mmHg/kg for systolic pressure and -0.2 (95% CI: -4.1, 3.7) mmHg/kg for diastolic pressure. The results suggest that in-utero growth restriction in twins is not a major determinant of their blood pressure as adults.     

Nongenetic factors associated with human handedness and footedness in Japanese twin children

Objective The aim of this study is to clarify the factors related to the handedness and footedness of twins using two of the largest databases on Japanese twins available. Methods The first group consisted of 1,131 twin pairs, all school children either 11 or 12 years old (S group), and the second group consisted of 951 twin pairs of different ages (1–15 years) in several maternal associations (M group). All data were gathered using a questionnaire. Factors associated with the handedness or footedness of twin individuals were analyzed by univariate and multivariate logistic analyses. Results Multivariate logistic analysis showed that for handedness, birth year (OR=1.02) and neonatal asphyxia (OR=1.62) were selected in the S group, and sex (OR=1.34), the age of twins (OR=1.56), parity (OR=1.31), gestational age (OR=1.58), and family history (OR=1.82) were selected in the M group. for footedness, birth complications (OR=1.37) were selected in the S group, and sex (OR=1.33), the age of twins (OR=1.69), gestational age (OR=1.83), and family history (OR=2.49) were selected in the M group. Factors associated with handedness and footedness specific to twins, such as zygosity, placentation, birth order within twin pairs and the sex of the cotwin, were not found, although being a twin might have some effects. Conclusion It was concluded that factors that affect handedness or footedness in general, such as sex, birth year, age, parity, neonatal asphyxia, gestational age, birth complications, and family history, seem to have stronger effects on handedness and footedness than being a twin.     

Twin–singleton influence on infant development: a national birth cohort study

Background While studying the development of twins, gestational age and birthweight were suggested as two of the major mediators to be considered. In addition, maternal age, maternal education, parental income and assisted reproductive technologies (ART) also should be considered as moderators. Thus the purpose of this study was to investigate the mediators and moderators of twin and singleton development. Methods Being a national birth cohort study, 21 648 infants were randomly selected and developmental measures were assessed at 6 and 18 months post partum. Children's development at 6 and 18 months were measured using the high reliable Taiwan Birth Cohort Study instrument, which measures children's development in four domains of gross motor, fine motor, language and social development. Additionally, maternal sociodemographics including maternal age, maternal education and parental income; children's characteristics including gender, birthweight, gestational age, single or multiple births, ART or natural conception information were also collected. These data were analysed using a three‐step multiple linear regression analysis and further validated using structural equation modelling. Results Parental sociodemographics, children characteristics and being twin all had effect on children's development. Additionally, ART and twin were mediators between maternal age and children's development. Mothers aged over 40 were more likely to choose ART, thus increases their likelihood of having twins. Additionally, mothers aged over 40 were more likely to give birth to premature or low‐birthweight babies, regardless if they were twin or not. Twins had a higher prevalence of prematurity or low birthweight, which also affected their development in all four domains at 6 and 18 months. Thus prematurity and low birthweight were mediating factors between twin and children's development; with these two mediating factors controlled, there were no difference between twin and singleton development. Conclusions The conceptual construct of structural equation modelling showed these factors interacted and influenced children's development through multiple pathways. Medical intervention may facilitate children's development through prenatal growth and premature care.     

The relationship between maternal birthweight and gestational age in twins and singletons and those of their offspring in Norway

In order to elucidate whether maternal plurality affects offspring intrauterine growth, the relationship between birthweight and gestational age of twins and singletons and those of their first singleton liveborn children in Norway was studied using data from the Medical Birth Registry. The population-based sample consisted of 49 698 mother–offspring pairs (48 842 with singleton and 856 with twin-mothers). In bivariate analyses, no significant differences in mean birthweight and gestational age of offspring of twin and singleton mothers were found, although the mean birthweight and gestational age of the twin-mothers themselves were significantly lower than those of singletons (819 g and 14 days respectively). In multiple regression analysis, the expected birthweight of offspring was 230.3 g (95% CI: 193.2–267.4 g) higher when the mother was a twin than when the mother was a singleton, when controlling for non-standardised maternal birthweight. When adjusting for relative maternal birthweight ( z -score), the association between maternal plurality and offspring birthweight was not statistically significant. The results suggest that being born as a twin has no substantial consequences on offspring growth in utero and show that mean differences in birthweight between twins and singletons should be standardised when both groups are included in multivariate studies.     

试管双胎婴儿与自然妊娠双胎婴儿临床特征比较分析

目的 探讨试管双胎婴儿与自然妊娠双胎婴儿临床特征的差异性,为完善试管双胎婴儿的临床管理提供指导。方法 选取172对试管双胎婴儿和476对自然妊娠双胎婴儿为研究对象,收集其性别、母亲年龄、出生身长、出生体重、早产、胎龄、出生后合并症、NICU住院、出生缺陷、死亡等信息,比较两组婴儿间的差异。结果 试管婴儿母亲生育时年龄、双胎体重差、体重差异率以及新生儿低血糖/高血糖、感染、心脏相关疾病、呼吸系统疾病发生比例均高于自然妊娠婴儿;试管婴儿胎龄小于自然妊娠婴儿,以上差异均有统计学意义(P＜0.05)。结论 应加强试管双胎婴儿分娩的监测,注意新生儿血糖异常、感染、心脏相关疾病、呼吸系统疾病的发生,早期积极处理避免不良结局的发生。     

The influence of maternal age on very preterm birth of twins: differential effects by parity

For singleton births, parity can modify the effect of maternal age on birth outcomes such as low birthweight and preterm birth; however, it is unknown whether this relationship exists for twin births. As the rate of twin births increases among older women, it is important to understand how parity may influence the relationship between maternal age and adverse birth outcomes. The NCHS Matched Multiple Birth Data Set, which contains all twin births in the USA from 1995 to 1998, was analysed. Parity was grouped into two levels (primiparous--no prior live births, and multiparous--at least one prior live birth), and maternal age was divided into the following groups: 20-24, 25-29, 30-34, 35-39, and 40 years or more. Very preterm birth was defined as births occurring before 33 weeks. Logistic regression was used to obtain odds ratios (OR) to estimate the risk of very preterm birth, and to determine the relationships between parity, maternal age, and very preterm birth. Among primiparae, women 40 years and older had a reduced risk of very preterm birth compared with women of 25-29 years (OR 0.74 [95% CI=0.66, 0.84]). Among multiparae, women 40 years and older had the same risk of very preterm birth compared with women of 25-29 years (OR 1.00 [95% CI=0.90, 1.12]). However, stratification by education revealed that the age gradient was limited to women with >12 years education among primiparae. The effect of maternal age on very preterm birth of twins differs according to parity. To some extent, that effect is further modified by education. Therefore, future analyses of maternal age and twin birth outcomes should account for measures of obstetric history and other factors, which may influence these results.     

双胎发育不均衡早产儿早期并发症及纠正年龄12月内神经系统预后分析

目的 分析双胎发育不均衡早产儿生后早期并发症及纠正年龄12月时神经发育的差异,为双胎发育不均衡早产儿预防并发症提供依据。方法 采用前瞻性队列研究,选择2016年1月1日-2017年12月31日郑州大学第三附属医院新生儿科收治的活产、双胎且出生体重差异≥25%,除外双胎输血综合征的早产儿67对,分为轻胎组67例,重胎组67例,观察其生后早期并发症和纠正年龄12月以内的神经发育发育情况。结果 1)轻胎组发生新生儿呼吸窘迫综合征(NRDS)、喂养不耐受和感染性疾病的比例,住院期间放弃或死亡例数及住院天数均高于重胎组,差异有统计学意义(t=4.418、4.251、3.983、5.858、4.733,P＜0.05)。2)双胎均痊愈出院者共55对,随访至纠正年龄12月者43对。在不同出生胎龄中(＜32周,32~33⁺⁶周,34~36⁺⁶周),轻胎组新生儿行为神经测定(NBNA)得分均显著低于重胎组(6月龄:t=3.735、2.494、2.129;12龄:t=4.850、3.269、3.381,P＜0.001);纠正年龄6月和12月龄时,不同胎龄中,轻胎组与重胎组智力发育指数(MDI)差异均无统计学意义(P>0.05),而轻胎组运动发育指数(PDI)均显著低于重胎组(t=4.269、3.233、2.578,P＜0.01)。结论 双胎发育不均衡的早产儿中,低出生体重小者生后早期并发症多,预后不良的发生率较高,要严密随访,尤其注意运动能力的发育状况。     

Maternal birthweight and outcome of twin pregnancy

There is evidence from singletons that maternal birthweight is positively related to offspring gestational length and birthweight, and some evidence of an inverse relationship with preterm birth. Among twins very preterm birth is the major cause of neonatal mortality and of immediate and later morbidity, including neurodevelopmental impairment. We hypothesised that the relationship between maternal birthweight and gestational length would be more evident in twin than in singleton pregnancies, as there is more variation in gestation in the former. Among 131 singleton mothers carrying twins, there was weak evidence of a positive relationship between maternal birthweight and twin gestational length (+0.6 weeks [95% CI -0.05, +1.3] per kg increase in maternal birthweight, but stronger evidence among 56 of these who went into labour spontaneously (+1.9 weeks [+0.7, +3.1], P = 0.003 for interaction). In the latter group we estimated that the odds of very preterm birth (at <32 weeks) were reduced by 50% [95% CI 10%, 82%] per 250 g increase in maternal birthweight. In the whole cohort, and in this subgroup, maternal birthweight was strongly positively related to both twin offspring total birthweight and total placental weight. Our data, consistent with intergenerational programming of early development, suggest the possibility of a stronger and more clinically relevant association among twins than among singletons. Nevertheless, our sample size was modest and this finding needs to be confirmed in a larger cohort.     

Maternal anthropometric measurements and other factors: relation with birth weight of neonates

The objective of this study was to examine the influence of anthropometric measurements of pregnant women, gestational weight gain, fundal height, and maternal factors, namely age, education, family income, parity along with maternal hemoglobin, on birth weight of neonates. A cross sectional study was performed in Khoy City in north west of Iran. Four hundred and fifty healthy pregnant women in the age between 16-40 years were selected for this study from seven health urban centers and one referral hospital. Findings showed that the mean age, height, fundal height, maternal weight, and gestational weight gain during pregnancy were 26.1 years, 159.1 cm, 32.9 cm, 72.0 kg, 11.8 kg respectively. The mean birth weight of neonates was 3.2 kg and 11% of neonates showed low birth weight. Age, family income, maternal height, weight, gestational weight gain and fundal height were significantly associated with birth weight of neonates. Using binary logistic regression analysis, fundal height, maternal hemoglobin, family income and gestational weight gain of pregnant women could be considered as predictive factors of birth weight of neonates.