560例低出生体重儿分析

随着医学科学的发展和围产保健工作的进一步加强、完善,新生儿死亡率已明显下降,但低出生体重儿的死亡率仍较高,降低低出生体重儿的发生率,发病率及死亡率是降低新生儿死亡率的关键。为此对我院1988年12月至1991年11月在我院出生的560例低出生体重儿加以分析,从中找到薄弱环节,以指导工作。     

低出生体重儿死亡原因分析

低出生体重儿死亡原因分析杨秀芬，姚穗（湖南省人民医院４１０００２）１９９０～１９９３年间在我院住院分娩的围产儿３３８５人，发生低出生体重儿１５２人，发生率为４．４９％。低出生体重儿死亡４０例，死亡率为２６３．１６‰。现将低出生体重儿的死亡原因和相关因...     

4379例婴儿出生体重分析

目的:回顾性分析1996~2007年12年间婴儿的平均出生体重,了解低出生体重儿、早产儿、巨大儿和正常体重儿的发生率及影响因素。方法:对1996年1月~2007年12月在郑州大学第一附属医院围产保健门诊进行围产保健系统管理登记在册、资料完整的4 379例婴儿的出生体重进行回顾性分析。结果:4379例婴儿平均出生体重为3 370.37g。12年间婴儿平均出生体重无统计学差异(P>0.05)。男婴平均出生体重高于女婴,差异有统计学意义(P<0.05)。早产儿发生率3.91%;低出生体重儿发生率2.19%;巨大儿发生率7.76%。婴儿平均出生体重与双胎及多胎婴儿的平均出生体重差异有统计学意义(P<0.05)。结论:导致低出生体重儿的主要原因是早产。预防早产、降低巨大儿的发生率,是今后围产保健工作中的一项重要内容。     

中国城市活产儿低出生体重比的描述性研究

为了解我国城市活产儿低出生体重比的发生与分布情况,本文分析了1988～1989年全国城市围产保健监测系统中10个省市29087份围产保健过录卡资料。结果表明,两年中共监测活产儿总数为28878例,低出生体重(<2500g)儿有1094例,活产儿低出生体重比为3.79％。男,女性别比为1:1.37。低出生体重比与母亲一般特征(年龄、身高、体重)、母亲孕朗疾病(阴道出血、妊高征、胎盘早剥、前置胎盘、羊水过少)、围产保健(产前检查次数)及孕周有关。本研究未提示低出生体重比在地区分布及时间分布方面的显著性差异。     

230例低出生体重儿原因分析

低出生体重儿对外界环境适应能力差、抵抗力低，是围产期保健的重点人群，低出生体重是新生儿患病率和死亡率的重要影响因素。低出生体重儿的围产期死亡率较正常儿高8倍，且活婴日后常有智力和运动功能发育障碍。发达国家的低出生体重儿以早产为主．而发展中国家以宫内发育迟缓为主。为了解本地区低出生体重儿发生的危险因素，近年来低出生体重儿发生率的变化，降低低出生体重儿发生率．笔者对本院2000年1月～2003年12月出生的230例低出生体重儿进行回顾性分析。     

382例低出生体重儿临床分析

目的:探讨低出生体重儿的发病因素、发生率、合并症及死亡原因,为预防低出生体重儿的发生提供参考依据。方法:回顾性分析2004年1月～2010年1月河池市妇幼保健院新生儿科收治的382例低出生体重儿的临床资料,分析、比较其发病因素、发生率、合并症及死亡原因、死亡率。结果:382例低出生体重儿发病原因均为母亲妊娠期各种因素。常见合并症有产前宫内窘迫、出生后窒息、高胆红素血症、吸入性或感染性肺炎、颅内出血、缺氧缺血性脑病、硬肿症、低血糖、新生儿呼吸窘迫综合征、肺出血、坏死性小肠结肠炎等;低出生体重儿发生率为51.63‰,死亡率为157.07‰;死亡以早产极低出生体重儿为主。结论:加强孕期保健是预防低出生体重儿发生的重要措施之一。     

绍兴市低出生体重儿发生率及其影响因素

[目的]探讨低出生体重儿发生的危险因素,为减少低出生体重儿发生提供科学依据.[方法]对2003年10月1日～2004年9月30日出生的179例低体重儿采用问卷的方法进行1：2病例对照研究.[结果]绍兴市低出生体重儿发生率为3.9%,低出生体重儿发生的危险因素依次是早产（OR=86.61）,家族低出生体重儿史（OR=5.37）,母亲合并内科疾病（OR=4.34）,母亲患妊娠高血压综合征（OR=2.65）,女婴（OR=2.54）,低收入（OR=1.68）,产检次数≤5次（OR=1.64）.[结论]绍兴市低出生体重儿发生率处在较低水平,孕周不足、低出生体重家族史、母亲合并内科疾病、患妊娠高血压综合征、家庭低收入、产检次数少是绍兴市低出生体重儿发生的危险因素,值得重视.     

足月低体重儿212例临床分析

随着围产医学的发展．围产期保健的加强及产前检查的系统完善化．降低了低体重儿的发生率，减少了产儿死亡率．现将山西省人民医院5年来足月低体重儿212例作一回顾性分析．     

与出生低体重有关的孕母情况的研究

为了研究与出生低体重有关的孕母情况 ,采用病例对照研究的方法 ,对 48例低出生体重儿和 43 3例非低出生体重儿的母亲进行流行病学调查分析。结果显示 :孕期妊高征 (OR=1.687,95% CI:1.198～ 2 .3 75)、孕周(OR=0 .157,95% CI:0 .0 98～ 0 .2 53 )、产次 (OR=3 .2 51,95% CI:1.188～ 8.90 0 )与低出生体重的发生有关。提示 :加强围产期保健 ,减少妊高征、早产和经产 ,健全农村围产保健机构 ,可有效降低出生低体重的发生率     

63例活产低体重儿相关因素分析

低体重儿是围产儿死亡的主要原因之一 ,为了进一步了解低体重儿发生的有关影响因素 ,减少低体重儿的出生 ,现将 63例活产低体重儿进行分析如下 :1　对象与方法1.1　对象选取 2 0 0 1年 1～ 12月 ,在海曙、江北两辖区内出生体重小于 2 5 0 0 ｇ的 63例活产低体重儿 (不包括死胎、死产和双胎 )为观察组 ,同时从孕妇围产保健卡册中随机抽取同期内分娩的孕妇 65例 (新生儿出生体重均大于 2 5 0 0ｇ)作为对照组 ,进行对比分析。1.2　方法孕妇围产保健卡册由中美预防出生缺陷与残疾项目办提供 ,按围产保健要求 ,进行孕期检查 ,并详细记录。1.3　统…     

Perinatal deaths and childbirth healthcare evaluation in maternity hospitals of the Brazilian Unified Health System in Belo Horizonte, Minas Gerais, Brazil, 1999

This paper analyzes the association between perinatal mortality and factors related to hospital care during labor, considering that healthcare assessment is needed in order to reduce perinatal mortality. A population-based case-control study was conducted with 118 perinatal deaths (cases) and 492 births (controls) that took place in maternity hospitals of the Brazilian Unified Health System (SUS) in Belo Horizonte, Minas Gerais, Brazil. Male sex, prematurity, diseases during pregnancy, low birth weight, newborn diseases, lack of prenatal care, lack of partograph use during labor, and less than one fetus assessment per hour during labor were significantly associated with perinatal deaths. In the multiple regression analysis, lack of partograph use during labor and type of hospital were associated with perinatal deaths. These results indicate inadequate quality of care in maternity hospitals and show that health services structure and health care process are related to perinatal mortality due to preventable causes.     

Jail incarceration and birth outcomes

This study examined the relationships between jail incarceration during pregnancy and infant birth weight, preterm birth, and fetal growth restriction. We used multivariate regression analyses to compare outcomes for 496 births to women who were in jail for part of pregnancy with 4,960 Medicaid-funded births as matched community controls. After adjusting for potential confounding variables, the relationship between jail incarceration and birth outcomes was modified by maternal age. Relative to controls, women incarcerated during pregnancy had progressively higher odds of low birth weight and preterm birth through age 39 years; conversely, jail detainees older than 39 years were less likely than controls to experience low birth weight or preterm birth. For women in jail at all ages, postrelease maternity case management was associated with decreased odds of low birth weight, whereas prenatal care was associated with decreased odds of preterm birth. Local jails are important sites for public health intervention. Efforts to ensure that all pregnant women released from jail have access to enhanced prenatal health services may improve perinatal outcomes for this group of particularly vulnerable women and infants.     

119例出生低体重儿母婴情况分析

出生体重过低是造成围产儿死亡的主要原因之一。要降低围产儿死亡率,必须降低低体重儿出生率。本文通过对119例出生低体重儿母婴情况临床分析,探讨发病因素。造成出生体重过低的原因有早产、妊高征、胎膜早破、双胎、畸形儿及造成胎盘功能不全的各种因素。故应加强围产期保健。对于危险因素应早发现,早治疗,以便减少低体重儿出生率。     

Declines in nonwhite and white neonatal mortality in Mississippi, 1975-80

Linked birth and death records provided the population for an investigation of declines in nonwhite and white neonatal mortality rates (NMR) in Mississippi between 1975 and 1980. The effect of changes in the characteristics of women giving birth and in perinatal care on declining NMRs was analyzed. A decomposition of the difference in the 1975-76 and 1979-80 NMRs was performed to determine whether declines in NMRs were due to shifts in population characteristics or in characteristic-specific rates. Between 1975 and 1980, the NMR declined significantly by 1 death per 1,000 live births per year among nonwhites and by 0.8 per 1,000 among whites. Increases in the number of prenatal visits during the study period were associated with part of this decline, especially for nonwhites. The effect of rising use of prenatal care on NMRs was not, however, a result of shifts in the birth weight distribution. The decrease in NMRs was also associated with declining birth weight-specific rates; 75 percent of the decrease in rates was noted among low birth weight infants. Shifts in the distribution of birth weight and in maternal characteristics had little effect on declining NMRs. A strong commitment of the Mississippi State Board of Health to provide prenatal care to indigent women may be responsible for the large increases in use of prenatal care among Mississippi women. The decline in NMRs among low birth weight infants is likely linked to greater availability of specialized care for the sick neonate, although survival of these infants increased across the State, even where specialized care was not available.     

Interpretative views on Hispanics' perinatal problems of low birth weight and prenatal care

From a public health perspective, there is a need to recognize that Hispanics, and in particular Mexican Americans, are a very heterogeneous group. They represent all shades of acculturation, education, income, and citizenship status. As this minority group continues to increase in numbers, pertinent information about their perinatal health problems in the context of their sociocultural characteristics will be required. This review examines critically the recent literature related to low birth weight and prenatal care and suggests alternative ways to address these perinatal health issues. Low birth weight is examined in the context of the problem of intrauterine growth retardation and the potential mechanisms and consequences of different types of growth limitation in utero which have not been studied in this population. The use of prenatal care by Mexican American women and its association with birth weight is examined as an indication of maternal behavior or as a health care intervention. The implications for public health policy are discussed in relation to the identification, interpretation, and evaluation of these perinatal health issues in this minority population.     

深圳市罗湖区1996-2005年围产儿死亡情况分析

目的掌握罗湖区近10年围产儿死亡水平、死因分布情况及其变化,为制定有效干预措施提供依据。方法对罗湖区1996—2005年围产儿死亡资料进行回顾性分析,对不同户籍类型死亡原因、死亡率等进行对比分析,并按年限分成前、后5年两组[A组(1996—2000年)、B组(2001—2005年)],对死亡率、死因等进行对比分析。结果10年来罗湖区围产儿死亡总率总体变化不大,流动人口高于暂住和常住人口,前5位死因依次为畸形、早产儿、脐带和胎盘因素、孕母合并症和并发症,前后5年死因顺位不同。结论应制定有关措施,不断提高畸形的孕期筛查,加强早产和低出生体重、出生窒息的预防和治疗抢救,加强对流动人口的保健管理,以便有效降低围产儿死亡率。     

围产儿死亡影响因素的配对病例对照研究

目的:探讨影响围产儿死亡的高危或保护因素,以便采取有针对性的措施,降低围产儿死亡率。方法:以1994~2002年度在广州市荔湾区死亡的736例围产儿为病例组,采用配对病例对照研究的方法,对可能影响围产儿死亡的30项常见因素进行单因素分析和多因素分析。结果:有9个变量进入了多因素条件Logistic回归方程。其中围产儿死亡的危险因子有出生缺陷、妊娠高血压综合征、产妇及其配偶文化程度低、羊水过多或过少、配偶职业是农民、早产、低出生体重。保护因子有产检次数多、剖宫产。结论:针对结果提出了今后在提高围产保健水平、降低围产儿死亡率工作中要采取的有效措施。     

The Impact of Migration on Pregnancy Outcomes Among Mexican-Origin Women

To examine the association between individual-level and state-level migration status in the United States (US) and the risk of preterm and low birth weight infants among Mexican-origin women. We performed secondary analysis of the 2003 US birth certificate data for 641,474 infants born to Mexican-origin Latina women. The dependent variables were prematurity and low birth weight. The primary independent variables were individual- (maternal) and state-level migration status. Logistic regression analysis estimated the relationship between maternal and state-level migration status, maternal and infant factors, and the risk of prematurity and low birth weight. Women who were born in Mexico had less education and use of prenatal care than US-born, Mexican-origin women but also fewer preterm or low birth weight infants. After adjusting for maternal and infant characteristics, women who were born and resided in Mexico at delivery were 37–64 % less likely to deliver preterm or low birth weight infants, and women who were born in Mexico and resided in the US had a 20–21 % lower risk as compared to women who were born and resided in the same US state. Women who delivered in states with a higher proportion of Mexican-origin mothers were slightly more likely to deliver a preterm infant and slightly less likely to give birth to a low birth weight infant. These findings support the perinatal advantage of Mexican-born women and provide evidence that both individual- as well as state-level migration factors influence perinatal outcomes.     

广州市社区低出生体重儿相关因素分析

目的为探讨低出生体重儿围产期相关因素及防治措施,针对病因进行防治,提高出生人口素质,降低新生儿死亡率。方法回顾性分析广州市天河区天园街和员村街2001~2006年低出生体重儿的相关危险因素及低出生体重儿的发生率。结果低出生体重儿的发生率3.81%,低出生体重儿发生原因与分娩孕周、双胎妊娠有很大关系,同时与胎膜早破、妊娠期高血压疾病、孕期贫血、胎儿生长受限、胎盘因素、参加孕检的次数也有一定关系。结论做好婚前生育知识的宣传教育,强调婚检的重要性,不断提高孕妇的自我保健意识,完善妇幼保健网络,预防早产,及时发现和治疗高危因素,规范高危门诊,是降低低出生体重儿发生率的有效的防治措施。     

四川乐山地区308例脑性瘫痪儿童危险因素的病例对照研究

目的：了解与小儿脑性瘫痪（脑瘫）有关的致病危险因素。方法：采用整群抽样的方法作横断面调查四川乐山地区1-6岁儿童脑瘫的患病情况。并用1：2病例-对照研究了解脑瘫致病的危险因素。结果：调查该地区1-6岁儿童148 723名,诊断为脑瘫者308人,患病率为2.07‰。低出生体重儿、双胎孪生、早产儿脑瘫患病率明显增高,分别是正常出生体重儿童、单胎、足月产儿的16.32倍、4.16倍和22.21倍。单因素logistic分析显示影响脑瘫发生的因素涉及及多种病因。多因素logistic分析脑瘫的危险因素为在家中分娩、出生后5min Apgar评分低、孩子生后1个月内患病、母亲孕期感冒发热、孕期蛋白质（肉食和禽蛋）摄入少以及文化程度低等。结论：该地区小儿脑瘫的患病率及其特点与发达国家相当,其相关危险因素主要集中在孕期和围产期,涉及母亲、儿童、环境和遗传诸多方面,因此重视孕期和围产期的母婴保健是减少小儿脑瘫患病率的重要手段。