双胎儿童智能发育的影响因素及预防

目的探讨出生体重及父母文化程度对双胎儿智能发育的影响及预防.方法出生体重及父母文化程度的资料采取复习病案结合随访调查所获得,对每个儿童进行绘人智能测验.结果出生体重＜2500g儿童的绘人能力商明显低于出生体重≥2500g组,P＜0.05.父亲文化程度的高低对子女的智力影响较小,而母亲文化程度的高低对子女的智力有一定影响.结论加强围产期保健,避免早产和降低低出生体重儿出生率,提高母亲的文化素质是预防低智能儿童的重要措施.     

305例低出生体重儿发生的相关因素回顾性分析

目的探讨低出生体重儿发生率及相关因素，为有关部门制定政策和预防措施提供依据。方法对我院2003年1月～2008年12月出生的305例低出生体重儿进行回顾性分析。结果低出生体重儿发生率3．07％（305／9948）。2003年-2008年6年间各年度低出生体重儿的发生率没有明显变化，其中早产发生率36．72％，是低出生体重儿发生的第一因素，而双胎、妊高征、胎盘和胎膜因素等是造成胎儿宫内发育迟缓从而引发低出生体重的重要因素。结论降低早产的发生加强孕晚期保健管理是降低低出生体重儿的发生，提高儿童生命早期质量，降低婴儿死亡率的重要环节之一。     

低出生体重危险因素调查干预效果分析

目的对照分析影响低出生体重发生的危险因素,并通过危险因素的干预研究探讨降低出生体重儿的有效措施。方法采用病例对照研究,对江门地区分娩量最大的14间助产机构住院分娩孕妇进行问卷调查和病例摘录,调查与低出生体重发生可能相关的危险因素,根据发现的危险因素结合实际情况设计干预方案,探讨强化健教、高危管理、营养指导、心理疏导为主的综合产前干预措施对降低低出生体重儿的防控效果。结果干预组的低出生体重儿发生率明显下降,孕妇的健康知识知晓率、健康行为和心理状况均有明显的改善。结论通过综合产前干预措施可有效降低低出生体重儿的发生。     

十年间482例低出生体重儿死因分析及干预措施

十年间我院共分娩33190例，低出生体重儿的发生率为70.08‰。，死亡率互83．76‰，占围产儿死亡总数的61．4％，低体重儿死亡率是正常足月儿死亡率的M．5倍，2623例低出生体重）种，早产低体重）儿占43．53％，A亡率为309．11％，是足月死亡率（87．10‰）的3．5倍，以上各组经统计学处理均有显著差异。死因顺位：早产及小村儿；畸形；母亲合并症；硬肿症；窒息移胎；胎盘因素；脐带因素。笔者认为：降低低出生体重儿出生率及加强生后监护是降低日产儿死亡率的重要措施。     

围产期低体重儿1103例临床分析

目的探讨围产期低体重儿的死亡原因及其与孕妇一般社会因素的关系。方法对我院2000年1月至2006年1月围产期低体重儿1103例临床资料进行回顾性分析。结果低体重儿的发生率与孕妇孕龄、年龄、职业、文化程度及妊娠并发症和合并症有着密切的关系。结论提高全民文化素质,加强农村围产期保健,积极治疗孕妇并发症、合并症,大力宣传优生优育、避孕知识,避免过早或过晚生育,能够降低低出生体重儿的发生。     

早产低出生体重儿临床管理(附24例报告)

目的 总结临床早产低出生体重儿管理治疗经验，提高管理治疗水平，提高早产儿存活率，降低致残率。方法 早产低出生体重儿24例，通过①体温管理，②呼吸管理，③营养管理，④治疗管理，⑤预防感染，⑥严密监护等措施，观察患儿临床经过，并随访其预后。结果 通过良好的临床管理，早产低出生体重儿临床经过良好，生存率较高，病程缩短，预后较好。结论 早产低出生体重儿应加强环境温度管理、生命体征检测、预防感染、支持营养，用药简单勿滥用。     

低出生体重儿的发生与母亲既往生育史的相关性分析

目的探讨母亲既往生育史对单胎活产低出生体重儿发生的影响因素。方法选取375名住院产妇所生的单胎活产低出生体重儿（LBW）,与同期分娩的单胎活产正常体重儿5157例进行病例对照分析,比较母亲既往生育史对低出生体重儿发生的影响。结果既往自然流产史、早产史和不良孕产史是LBW发生的危险因素（OR=1.57 95%CI1.110-2.25）、（OR=4.84 95%CI 2.01-11.66）、（OR=2.09 95%CI 1.22-3.57）,并且主要针对于早产LBW（OR=1.6595%CI 1.11-2.44）、（OR=6.55 95%CI 2.70-15.91）、（OR=2.18 95%CI 1.21-3.91）,既往低出生体重史是足月LBW发生的危险因素（OR=7.93 95%CI 1.72-36.46）结论 LBW的发生与既往自然流产史、早产史、不良孕产史、低出生体重史密切相关。对以上这些妇女再次怀孕的孕前、孕期均应做好保健服务,以有效减少LBW的发生。     

产妇孕期被动吸烟与低出生体重症例对照研究

为分析母亲孕期被动吸烟与低出生体重的关系，采用群体匹配病例对照研究方法，对1999年3月－2000年4月间在沈阳市妇婴医院等14家医院分娩的非主动吸烟的产妇孕期被动吸烟情况与低出生体重关系进行分析。结果表明：孕期被动吸烟可能是低出生体重危险因素，且孕期被动吸烟的时间与低出生体重发生存在剂量反应关系（x^2趋势＝32．42；P＜0．01）。在控制产女不良孕产史等因素后，被动吸烟孕妇分娩出低出生体重儿的危险性为非被动吸烟孕妇的3．176倍（OR95％CI，1．868－5．401），且被动吸烟与孕妇文化程度对出生体重可能存在协同作用（协同作用指数为3．16）。     

高危新生儿血糖早期监测的临床价值

目的了解高危新生儿低血糖发生情况、探讨低血糖病因和降低低血糖发生率及危害性措施，为临床防治提供依据。方法对住院的1026例高危新生儿在生后3d内进行血糖监测。结果高危新生儿低血糖发生率6．53％；早产儿组较之于足月儿组、低出生体重儿和巨大儿组较之于正常出生体重儿组、小于胎龄儿组较之于适于和大于胎龄儿组，低血糖发生率明显增高（P〈0．01）。结论对高危新生儿进行血糖监测很有必要，并尽旱喂养，及时处置。     

212例极低出生体重儿的管理

我院1996～2000年住院极低体重儿212例,占同期新生儿住院总数2156例的9.83％。为降低体重儿的病死率,提高治疗和护理管理措施进行探讨。 临床资料 一般资料 212例中男110例,女102例。平均胎龄26周,平均出生体重1236g,小于1000g22例,1000～1500g190例,最低出生体重800g。212例极低体重儿死亡54例,死亡率为     

Birth Outcomes of Koreans by Birthplace of Infants and Their Mothers, the United States versus Korea, 1995-2004

The acculturation effect of immigrant women on birth outcomes varies by race. We examined birth outcomes of three groups of births for the period 1995-2004, USA births to the USA-born Korean mothers, USA births to the non-USA-born Korean mothers, and births in Korea. In singleton USA births to both Korean parents, average birth weight was 3,294 g for the USA-born Korean mothers and 3,323 g for the non-USA-born Korean mothers. However, this difference was not significant, once controlled for other maternal sociodemographic, obstetric and medical factors. Low birth weight and prematurity prevalence were not different by maternal nativity between these two singleton groups. Average birth weight of all births including multiplets in Korea was 3,270 g, compared to 3,297 g for all USA-born infants including multiplets and births either to both or one Korean parents. This difference might have reflected a significantly lower educational attainment of mothers in Korea compared to Korean mothers in the USA. Low birth weight rate was consistently lower in infants born in Korea compared to the USA-born, but this difference became less, 4.2% and 4.6% respectively by 2004. These observations suggest that in the USA acculturation effect of Korean immigrants on birth outcomes is negligible.     

Clinical determinants of the racial disparity in very low birth weight.

BACKGROUND. Although the risk of very low birth weight (less than 1500 g) is more than twice as high among blacks as among whites in the United States, the clinical conditions associated with this disparity remain poorly explored. METHODS AND RESULTS. We reviewed the medical records of over 98 percent of all infants weighing 500 to 1499 g who were born in Boston during the period 1980 through 1985 (687 infants), in St. Louis in 1985 and 1986 (397 infants), and in two health districts in Mississippi in 1984 and 1985 (215 infants). The medical records of the infants' mothers were also reviewed. These data were linked to birth-certificate files. During the study periods, there were 49,196 live births in Boston, 16,232 in St. Louis, and 16,332 in the Mississippi districts. The relative risk of very low birth weight among black infants as compared with white infants ranged from 2.3 to 3.2 in the three areas. The higher proportion of black infants with very low birth weights was related to an elevated risk in their mothers of major conditions associated with very low birth weight, primarily chorioamnionitis or premature rupture of the amniotic membrane (associated with 38.0 percent of the excess proportion of black infants with very low birth weights [95 percent confidence interval, 31.3 to 45.4 percent]); idiopathic preterm labor (20.9 percent of the excess [95 percent confidence interval, 16.0 to 26.4 percent]); hypertensive disorders (12.3 percent [95 percent confidence interval, 8.6 to 16.6]); and hemorrhage (9.8 percent [95 percent confidence interval, 5.5 to 13.5]). CONCLUSIONS. The higher proportion of black infants with very low birth weights is associated with a greater frequency of all major maternal conditions precipitating delivery among black women. Reductions in the disparity in birth weight between blacks and whites are not likely to result from any single clinical intervention but, rather, from comprehensive preventive strategies.     

Pregnancy outcomes among Whites and Filipinos: A paradoxical birth weight-neonatal mortality relationship

Evidence from the Philippines suggests that, compared to Whites, infants born to Filipino women are more likely to be low birth weight. A paucity of information is available regarding birth outcomes of U.S.-born Filipinos. Using 1979–1987 Hawaii vital record data on single live births to resident mothers, this study compares the maternal characteristics and pregnancy outcomes of White and Filipino mothers, Filipino mothers were significantly more likely to be <18 years of age and single, and have lower educational attainment and less adequate utilization of prenatal care. Significantly higher percentages of very preterm, preterm, very low birth weight, low birth weight, and small for gestational age infants were found for Filipinos. The birth weight-specific neonatal mortality rates for Filipinos compared favorably to Whites except at the high end of the birth weight distribution. After taking into account maternal sociodemographic risk and prenatal care factors in a logistic regression, a significant ethnic difference in low birth weight persisted but was not found for neonatal mortality. These data may suggest that similar neonatal mortality rates among ethnic groups may be possible in the face of persistent birth weight distribution differences and add to the growing evidence that a single standard of low birth weight may be inappropriate as an universal indicator of health status risk in a multi-ethnic population. © 1993 Wiley-Liss, Inc.     

Racial differences in low birth weight. Trends and risk factors

To identify the risk factors responsible for differences in birth weight between blacks and whites, we investigated the effects of four maternal characteristics (age, parity, marital status, and education) on rates of very low birth weight (less than 1500 g) and moderately low birth weight (between 1500 and 2500 g). Using 1983 national data, we found that the black:white rate ratio was 3.0 for very low birth weight and 2.3 for moderately low birth weight. The four maternal factors had directionally similar but quantitatively different effects on very low and moderately low birth weight among blacks and whites. Furthermore, the racial differences in infants' birth weights were greater among low-risk than among high-risk mothers, especially for very low birth weight (black:white ratios of 3.4 and 1.7, respectively). We also examined secular trends in the rates of low birth weight among blacks and whites. Between 1973 and 1983, births of infants with moderately low birth weights decreased more among whites than among blacks, whereas births of infants with very low birth weights increased among blacks and decreased among whites. Fifteen percent of the decline in the rate of moderately low birth weight among whites could be attributed to favorable changes in maternal characteristics (primarily an increase in educational level). Among blacks, adverse changes in maternal characteristics (primarily an increase in births to unmarried women) accounted for 35 percent of the increase in the rate of very low birth weight. The adverse effects of childbearing by teenagers on the outcome of pregnancy among blacks appear to have been overemphasized. The persistence of large racial differences in birth weight, even among mothers at low risk, emphasizes the need for specific targeted interventions to achieve further improvements in infant health.     

Factors affecting birthweight of rural Australian Aborigines

AIM: To examine factors affecting birthweight of Aboriginal infants in the Kimberley region of north-west Australia. Research design: A retrospective study of maternal and infant health records obtained through routine data collection. Subjects and methods: Birthweight and length of 2959 infants born to 1822 women from 1986 to 1994 were analysed. Mothers and infants were matched using unique identification codes. Index births and subsequent births to the same mother were collated in order to examine relative birth order effects and to calculate birth intervals. RESULTS: Regression analysis showed significant associations between weight of the index birth and maternal age (p < 0.001), remoteness of locality (p < 0.01), sex of the infant (p < 0.001) and maternal height (p < 0.001). Length at birth was significantly associated with ethnicity of infant (Aboriginal vs Aboriginal/non-Aboriginal admixture, p < 0.05), sex (p < 0.001), remoteness (p < 0.01) and maternal height (p < 0.001). Similar associations were observed for second and subsequent births. Birth interval was not associated with birthweight or length. Low birthweight was also more common to Aboriginal mothers compared with mothers of Aboriginal/non-Aboriginal admixture (13.1% vs 9.2%; chi(2) = 5.1, p < 0.025) even though there were no differences in height between these two groups. Teenage mothers (< or =19 years) were no more likely to have low birthweight babies than older mothers. Of the variables examined, the only significant predictor of low birthweight was a previous low birthweight baby (relative risk = 4.45, p < 0.001). CONCLUSIONS: Short birth intervals and teenage births were not significant contributors to low birthweight in the present study. The high prevalence and duration of breastfeeding in the Kimberley may contribute to long average birth intervals. Pre-term birth, rather than intrauterine growth retardation, is likely to be the most common cause of low birthweight in this population.     

新生儿先天性甲状腺功能异常发病率与胎龄、出生体重关系的研究

目的探讨广西地区先天性甲状腺功能异常（包括先天性甲状腺功能减低症（CH）和高TSH血症）发病率与胎龄、出生体重的关系。方法对2009年9月～2010年12月广西新生儿疾病筛查中心筛查的新生儿,凡滤纸血促甲状腺素（TSH）〉8.0mIU/L者予以召回,进行甲状腺功能检查。结果 2009年9月～2010年12月共筛查220 844人,确诊先天性甲状腺功能异常200人,发病率为1/1104。其中,早产儿（胎龄〈37周）发病率为1/449,足月儿（37≤胎龄≤42周）发病率为1/1189,过期产儿（胎龄〉42周）发病率为1/206,过期产儿发病率高于早产儿及足月产儿（P〈0.05）。低出生体重儿﹙〈2500g）发病率为1/407,正常体重儿（2500～4000g）发病率为1/1236,巨大儿（〉4000g）发病率为1/376,低出生体重儿及巨大儿的先天性甲状腺功能异常发病率明显高于正常体重儿（P〈0.01）。结论先天性甲状腺功能异常的发病率与胎龄、出生体重密切相关,过期产儿、巨大儿、低出生体重儿的发病率较高。注意孕期保健防止过期产儿、巨大儿、低出生体重儿,对降低先天性甲状腺功能异常的发生有重大意义。     

Factors affecting birthweight of rural Australian Aborigines

Aim : To examine factors affecting birthweight of Aboriginal infants in the Kimberley region of north-west Australia. Research design : A retrospective study of maternal and infant health records obtained through routine data collection. Subjects and methods : Birthweight and length of 2959 infants born to 1822 women from 1986 to 1994 were analysed. Mothers and infants were matched using unique identification codes. Index births and subsequent births to the same mother were collated in order to examine relative birth order effects and to calculate birth intervals. Results : Regression analysis showed significant associations between weight of the index birth and maternal age ( p < 0.001), remoteness of locality ( p < 0.01), sex of the infant ( p < 0.001) and maternal height ( p < 0.001). Length at birth was significantly associated with ethnicity of infant (Aboriginal vs Aboriginal/non-Aboriginal admixture, p < 0.05), sex ( p < 0.001), remoteness ( p < 0.01) and maternal height ( p < 0.001). Similar associations were observed for second and subsequent births. Birth interval was not associated with birthweight or length. Low birthweight was also more common to Aboriginal mothers compared with mothers of Aboriginal/non-Aboriginal admixture (13.1% vs 9.2%; &#104 2 = 5.1, p < 0.025) even though there were no differences in height between these two groups. Teenage mothers ( &#114 19 years) were no more likely to have low birthweight babies than older mothers. Of the variables examined, the only significant predictor of low birthweight was a previous low birthweight baby (relative risk = 4.45, p < 0.001). Conclusions : Short birth intervals and teenage births were not significant contributors to low birthweight in the present study. The high prevalence and duration of breastfeeding in the Kimberley may contribute to long average birth intervals. Pre-term birth, rather than intrauterine growth retardation, is likely to be the most common cause of low birthweight in this population.     

Epidemiology and genetics of microtia-anotia: a registry based study on over one million births.

The epidemiology and genetics of microtia-anotia (M-A) were studied using data collected from the Italian Multicentre Birth Defects Registry (IPIMC) from 1983 to 1992. Among 1,173, 794 births, we identified 172 with M-A, a rate of 1.46/10,000; 38 infants (22.1%) had anotia. Of the 172 infants, 114 (66.2%) had an isolated defect, 48 (27.9%) were multiformed infants (MMI) with M-A, and 10 (5.8%) had a well defined syndrome. The frequency of bilateral defects among non-syndromic cases was 12% compared to 50% of syndromic cases (p = 0.007). Among the MMI only holoprosencephaly was preferentially associated with M-A (four cases observed upsilon 0.7 expected, p = 0.005). No significant variations were identified in the prevalence of non-syndromic cases by geographical area (range 0.62-2.37/10,000 births) or by five month time periods (range 0.21-2.58/10,000 births), nor was there evidence of time trends. When M-A cases were compared to controls, we found that mothers with parity 1 had a higher risk of giving birth to an MMI with M-A, and that mothers with chronic maternal insulin dependent diabetes were at significantly higher risk for having a child with M-A. MMI with M-A had higher rates of prematurity, low birth weight, reduced intrauterine growth, and neonatal mortality than infants with isolated M-A and controls. Babies with isolated M-A had, on average, a lower birth weight than controls; the difference was higher for females. The analysis of pedigrees and familial cases suggests an autosomal dominant trait with variable expression and incomplete penetrance in a proportion of cases, or a multifactorial aetiology. Three cases had consanguineous parents, but the absence of M-A among previous sibs does not support autosomal recessive inheritance.     

Normal pregnancy outcomes in a population-based study including 2,968 pregnant women exposed to budesonide

BACKGROUND: Inhaled corticosteroids are recommended as first-line therapy for pregnant women with moderate to severe asthma, although the effects on pregnancy outcome are uncertain. A low compliance with the recommendations might lead to inadequate control of asthma, which has been associated with adverse outcomes both for the mother and the infant. OBJECTIVE: To investigate whether the reported use of inhaled budesonide (Pulmicort) during pregnancy influences birth outcome. METHODS: Data were derived from the Swedish Medical Birth Register, which includes 99% of births in Sweden. During 1995 to 1998, 293,948 newborn infants were identified. Pregnancy outcomes were compared for mothers in Sweden reporting asthma medication usage with those reporting no asthma medication usage. RESULTS: The 2,968 mothers who reported use of inhaled budesonide during early pregnancy gave birth to infants of normal gestational age, birth weight, and length, with no increased rate of stillbirths or multiple births. The rate of caesarean births was higher among mothers who used asthma medication during their pregnancy than among the control group. CONCLUSIONS: The use of inhaled budesonide in Sweden is not linked with any clinically relevant effects associated with pregnancy outcome.     

Recent Trends in the Incidence of Multiple Births and Its Consequences on Perinatal Problems in Korea

The aim of this study was to survey multiple birth data and to analyze the recent trends of multiple births and its consequences on perinatal problems in Korea from 1991 to 2008. Data were obtained from the Korean Statistical Information Service. The total number of multiple births showed increasing trends. The multiple birth rate was maintained within less than 10.0 for the decade from 1981 to 1990. However, it increased gradually to reach 27.5 in 2008. The maternal age for multiple births was higher than for total live births. The mean birth weight of the total live births was 3.23 kg; for the multiple births it was 2.40 kg in 2008. The incidence of low birth weight infants (LBWI) among total live births was 3.8% in 2000 and 4.9% in 2008. For multiple births it was 49.2% and 53.0% during the same years. The incidence of preterm births among total live births was 3.8% in 2000 and 5.5% in 2008; for the multiple births it was 38.3% and 51.5% during the same years. The incidence of multiple births and its consequences on perinatal problems (preterm, LBWI, and advanced-maternal age) have been increased steadily over the last two decades in Korea.