产妇孕期被动吸烟与低出生体重儿关系

目的为进一步探索低出生体重儿发生的相关危险因素。方法对沈阳市妇婴等 15家医院分娩的部分产妇进行了低出生体重儿的病例对照研究。结果在控制孕妇患慢性疾病、生殖器官的畸形、严重妊娠反应、文化程度以及主动吸烟等混杂因素后 ,孕期被动吸烟分娩出低出生体重儿的危险性为非被动吸烟的 2 .95倍 (95 % CI2 .0 7～ 4 .2 1) ;自然流产、人工流产史、家族低体重史、孕前的 BMI、丈夫饮酒史、孕期服用解热镇痛药物以及职业接触有机物均可能是低出生体重儿的危险因素。结论加强围产期保健 ,控制孕妇被动吸烟及科学调整孕前体重将有利于降低低出生体重儿的发生率     

环境卫生与监测

050105　产妇孕期被动吸烟与低出生体重儿关系/张吉慧…∥中国慢性病预防与控制2002,10(6)251～254为进一步探索低出生体重儿发生的相关危险因素。对沈阳市妇婴等15家医院分娩的部分产妇进行了低出生体重儿的病例对照研究。结果,在控制孕妇患慢性疾病、生殖器官的畸形、严重妊娠反应、文化程度以及主动吸烟等混杂因素后,孕期被动吸烟分娩出低出生体重儿的危险性为非被动吸烟的295倍(95%CI207～421);自然流产、人工流产史、家族低体重史、孕前的BMI、丈夫饮酒史、孕期服用解热镇痛药物以及职业接触有机物均可能是低出生体重儿的危险因素。…     

产妇孕期被动吸烟对低出生体重儿发生情况的影响

目的:探讨产妇孕期被动吸烟对低出生体重儿发生情况的影响,分析二者的相关性。方法:采用随机抽样法选择2011～2012年在该院进行产前检查并分娩的产妇900例,有孕期被动吸烟史450例,无孕期被动吸烟史450例。分析两组低出生体重儿发生情况。结果:孕期被动吸烟是低出生体重儿发生的危险因素。结论:加强产前保健,避免产妇孕期被动吸烟有助于降低低出生体重儿的发生率,间接减少社会和家庭负担,提高出生人口素质。     

孕期被动吸烟对妊娠并发症及妊娠结局的影响

目的了解孕期被动吸烟发生情况,并探讨其对妊娠并发症及结局的影响。方法选取2012年4月―2013年3月在我国15家医疗保健机构分娩的8926例单胎活产产妇作为研究对象,使用自制调查问卷收集孕期被动吸烟发生情况、妊娠并发症和结局等信息,采用单因素和多因素Logistic回归分析模型分析孕期被动吸烟对妊娠并发症及结局的影响。结果共1801例产妇在孕期经历被动吸烟。控制混杂因素后,孕期经历被动吸烟的产妇妊娠期糖尿病(gestational diabetes mellitus,GDM)的发生风险是非被动吸烟者的1.359倍(95%CI:1.146~1.612,P<0.001),胎膜早破的风险为1.290倍(95%CI:1.095~1.520,P=0.002),早产的风险为1.367倍(95%CI:1.155~1.619,P<0.001),娩出低出生体重儿的风险为1.341倍(95%CI:1.079~1.668,P=0.008)。与非被动吸烟者相比,平均每周被动吸烟天数≥4天者胎膜早破、早产和低出生体重儿的发生风险分别为非被动吸烟者的1.402倍(95%CI:1.104~1.780,P=0.006)、1.690倍(95%CI:1.339~2.132,P<0.001)和1.584倍(95%CI:1.172~2.141,P=0.023)。结论被调查产妇孕期被动吸烟率较高,孕期经历被动吸烟能够增加妊娠期糖尿病、胎膜早破、早产和低出生体重儿的发生风险。     

重庆市低出生体重儿影响因素的病例对照研究

目的 研究重庆市低出生体重儿的影响因素,为预防和降低全市低出生体重发生率提供理论依据。方法 采用1∶1病例对照研究方法选取重庆市6所妇幼保健院住院分娩的326名低出生体重儿和同期住院分娩的326名正常新生儿作为研究对象,利用问卷进行调查,采用单因素和多因素条件Logistic回归分析所获资料。结果 低出生体重儿的发生可能与母亲一般情况(孕前BMI、受教育程度、家庭平均月收入等)、孕期情况(单胎、产前检查、妊娠期高血压疾病等)、生活习惯(吸烟、饮酒、被动吸烟等)和膳食营养(服用多种维生素片、食用鱼禽肉类、食用海产植物类等)有关。多因素分析结果显示,家庭平均月收入、单胎、孕期增重和产前检查是低出生体重儿的主要保护因素,妊娠期贫血是影响低出生体重儿的主要危险因素。结论 低出生体重儿的发生受多方面因素共同作用的影响,应采取综合措施降低低出生体重儿的发生率。     

母亲孕期被动吸烟及父亲饮酒与低出生体重儿关系研究

为了解母亲孕期被动吸烟，父亲经常饮酒两因素各自对娩出低出生体重儿的相对危险性，本文调查了２０１０例产妇，其中母亲孕期被动吸烟者１２５８例（６２．９％），丈夫经常饮酒者２８０例（１３．９３％）。结果表明：对多种影响因素进行调整后孕期被动吸烟母亲娩出低出生体重儿的相对危险性为孕期未被动吸烟母亲的１．９４倍。父亲经常饮酒而母亲娩出低出生体重儿的相对危险性是父亲偶尔饮酒的２．８３倍。研究提示：孕妇应尽量避免被动吸烟，同时在准备受孕前男方应戒酒。     

江门地区低出生体重儿发生影响因素的病例对照研究

目的探讨影响低出生体重发生的主要危险因素。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2015年8月-2016年5月间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一般人口学特征、孕产相关因素、孕妇慢性疾病史、孕妇感染史、孕期生活习惯、孕期营养状况、孕期心理健康、产妇月经史及生育史、产妇及配偶生活和工作环境等,探讨以上因素与低出生体重的关联及发现可能的危险因素。结果新生儿低出生体重的发生与父母的一般社会人口学特征、身高、体重及母亲的月经史和生育史、孕期的体力活动、孕期的保健行为、孕期的患病情况和营养状况有关。结论孕母积极获取保健知识、参加过孕妇学校、按时孕期产检是低体重发生的保护因素;孕期轻度体力劳动、工作和适度体育锻炼是降低低体重儿发生风险的保护因素;妊娠期高血压疾病、前置胎盘、胎盘早剥、胎膜早破、胎位异常都是新生儿发生低出生体重的显著危险因素,具有低出生体重儿分娩史及早产史也是新生儿发生低出生体重的显著危险因素,孕前BMI值偏低、孕期增重不足、早餐不规律是新生儿低出生体重发生的危险因素;而经常食用奶、豆类食物、海产品、内脏及服用钙补充剂则是降低新生儿低出生体重发生的保护因素。     

低出生体重影响因素分析

目的:分析低出生体重儿体格检查的一般情况并探讨影响低出生体重的因素。方法:调查产妇及新生儿父母亲的年龄、民族、文化程度、职业、吸烟饮酒史、既往疾病史、高血压家族史以及体格检查,产妇孕产史、妊娠并发症和合并症、分娩情况,新生儿出生情况、体格检查,同时对这些因素进行统计描述,并用二分类Logistic回归模型对低出生体重的影响因素进行分析。结果:单因素分析结果显示,家庭住址边远、婴儿母亲为少数民族、终止妊娠时间较早、父母亲受教育程度低、父母亲从事较重体力劳动职业、父母亲BMI值低、父亲存在既往病史、母亲孕期食用油种类、食用肥瘦肉比例不均、补充维生素不足、食盐量过多或过少、每周食用鸡蛋量少、每周食用鱼量少、家庭其他成员吸烟、母亲孕期与家庭成员相处不融洽以及存在产时并发症、产前检查次数较少、孕期增重少、双胎或多胎等可能是影响低出生体重的因素。多因素Logistic回归结果显示,产前检查次数较少、终止妊娠时间较早、孕期高血压和感染可能是低出生体重的危险因素。结论:母亲孕期相关因素可能会对低出生体重产生影响,加强孕期体格检查和卫生知识宣教可以有效降低低出生体重儿的发生率。     

重庆市足月低出生体重儿环境影响因素研究

目的探讨母亲孕期环境相关因素对足月低出生体重儿的影响,为制定相应的保健措施提供依据。方法采用病例对照研究方法,利用问卷对2014年4-8月在重庆市6所妇幼保健院住院分娩的84例足月低出生体重儿和283例正常对照组新生儿的父母进行现场调查,运用χ~2检验和非条件Logistic回归模型进行分析。结果单因素分析结果显示吸烟、被动吸烟、母亲孕期服用多种维生素片、食用蛋类、奶类及其制品、水果类、坚果类、主食摄入情况可能是发生足月低出生体重儿的影响因素。多因素分析结果进一步证实,被动吸烟(OR=1.89)、孕期食用蛋类(OR=0.61)、孕期主食摄入量少于孕前(OR=4.08)是发生足月低出生体重儿的主要影响因素。结论足月低出生体重儿的发生受多方面因素共同作用的影响,应采取综合措施来预防和控制足月低出生体重儿的发生。     

广州市萝岗区2011至2015年低出生体重儿危险因素分析

目的：探讨低出生体重儿发生的危险因素,为控制和降低低出生体重儿发生率提供参考依据。方法广州市萝岗区6家产科医院2011至2015年分娩的所有体重＜2500g的活产儿共1247例为病例组,随机抽取体重≥2500g新生儿2500例作为对照组。对两组间共25项因素进行回顾性调查和危险因素分析。结果单因素分析结果显示母亲身高＜150cm、孕前BMI＜18．5、产检＜5次、被动吸烟、孕期增重＜11．4kg、妊娠期高血压疾病、孕期感染、胎膜早破、早产、双（多）胎和前置胎盘11项因素在低出生体重的发生上差别有统计学意义（χ2值分别是51．048、98．717、9．041、42．930、12．057、54．664、55．672、21．827、1882．257、345．456、7．037,均P＜0．05）。多因素Logistic回归分析结果显示早产、双（多）胎、产检＜5次、被动吸烟、孕期增重＜11．4kg和前置胎盘是低出生体重儿发生的危险因素（OR值分别是42．966、5．389、1．431、1．775、2．293、1．393,均P＜0．05）。结论低出生体重的发生受多因素影响,早产、双（多）胎、产检＜5次、被动吸烟、孕期增重＜11．4kg和前置胎盘等因素可显著增加其危险性,应重视孕期的健康宣教和保健,加强高危妊娠的管理,以控制和降低低出生体重儿发生率。     

儿童孤独症发病危险因素的病例对照研究

目的 探讨儿童孤独症发病的相关危险因素, 为孤独症的防治提供理论依据。方法 采用成组病例对照研究, 对165例孤独症儿童和320例正常对照组儿童, 采用自编的孤独症危险因素调查表收集相关危险因素、家庭一般情况等资料, 用χ²检验分析两组儿童之间危险因素的差异。结果 病例组母亲高生育年龄(≥35岁)、有人工流产史、母孕期抑郁情绪史、母孕期被动吸烟史及父亲内向所占比例较正常组高(P<0.05), 进一步进行Logistic 回归分析显示母高育龄、孕期抑郁情绪、孕期被动吸烟、有人工流产史以及父亲性格内向为孤独症的危险因素。结论 母亲高龄生育、有人工流产史、孕期抑郁情绪、孕期被动吸烟以及父亲性格内向均可使儿童孤独症发病风险增高。     

Characteristics of preterm delivery and low birthweight among 113,994 infants in Alberta: 1994-1996

This study examined the impact of infant and maternal factors on preterm delivery and low birthweight (LBW) in Alberta between January 1, 1994 and December 31, 1996. Data on 113,994 births were collected from vital statistics registration birth data. Logistic regression models for preterm and LBW delivery suggested the key risk factors were multiple and still birth (odds ratios > 22.0). Other characteristics included female gender, birth defects, nulliparous women, maternal age 35 and greater, unmarried, history of abortion, maternal smoking, maternal street drug use, and having less than 4 prenatal visits (odds ratios 0.86-2.54). Interactions between smoking and alcohol, and smoking and parity were noted. Efforts to improve the currently low rates (8.2%) of smoking cessation during pregnancy are required. Social, economic and medical factors associated with delayed childbearing and birth outcomes should be investigated.     

孕期被动吸烟对新生儿出生体重影响的临床研究

目的 分析鄂州市孕期被动吸烟与新生儿低出生体重的关系。方法 采用1∶2病例对照研究方法, 对2008年1月1日-2011年12月1日间在鄂州市妇幼保健院分娩的1 080名20~30岁非主动吸烟的产妇孕期被动吸烟情况与新生儿低出生体重关系进行分析。结果 病例组产妇被动吸烟发生率(47.5%)明显高于对照组 (28.3%,P<0.001)。控制相关混杂因素后,孕期每周平均累积被动吸烟时间为1~3 d或超过3 d的产妇发生新生儿低出生体重的风险相比无被动吸烟的产妇增加1.54倍(OR=2.54,95%CI:1.81~3.57)和3.29倍(OR=4.29,95%CI:2.62~7.04),相应归因分值AFe分别为60.6%和76.7%。孕期产检次数增加到7次以上可以减少被动吸烟组产妇约53%(OR=0.47,95%CI:0.30~0.73) 的低出生体重儿的发生风险。 结论 孕期被动吸烟与新生儿低出生体重发生密切相关,且暴露时间与新生儿低出生体重发生风险存在很明显的剂量反应关系。     

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     

The exposure of nonsmoking and smoking mothers to environmental tobacco smoke during different gestational phases and fetal growth

We studied the impact of maternal exposure to environmental tobacco smoke (ETS) on birth weight (BW), low birth weight (LBW), and intrauterine growth retardation (IUGR) according to self-reported maternal smoking habits in a sample of 6,866 singleton births. We obtained data about parental characteristics and maternal active smoking (AS) and passive smoking at delivery via maternal questionnaires and medical records. We used three categories of smoking habits (nonsmokers and those who smoked 1-10 or >10 cigarettes per day) and defined ETS exposure as greater than or equal to 5 cigarettes per day smoked by others in the mother's presence. We used multiple regression and logistic regression procedures with adjustment for many associated covariates. We observed a significant reduction of the mean BW in infants of AS mothers. This reduction was only marginal for mothers who stopped smoking after recognizing their pregnancy. ETS exposure in 1,797 of 5,507 nonsmoking mothers reduced the mean BW of their infants by 53 g [95% confidence interval (CI), 24-82 g]. ETS exposure also significantly reduced BW in babies of AS mothers by 92 g (CI, 21-113 g) compared with BW of ETS-nonexposed AS mothers. The adjusted odds ratio (AOR) of LBW for ETS-exposed AS mothers was two times the LBW risk of ETS-nonexposed AS mothers(2.02; CI, 1.11-3.67); the AOR of ETS-exposed nonsmoking mothers was 1.51 (CI, 1.02-2.26). The AOR of IUGR for this group did not differ from unity (1.08; CI, 0.82-1.43). However, ETS exposure increased the AOR of IUGR for AS mothers from 1.64 (CI, 1.06-2.53) to 2.13 (CI, 1.70-2.67). ETS exposure reduced the BW of infants of nonsmoking mothers and contributed to additional BW reduction in infants of AS mothers. ETS exposure increased the risk of LBW but not that of IUGR in babies of nonsmoking mothers.     

上海市闵行区低出生体重儿危险因素研究

目的探讨影响上海市闵行区低出生体重儿(LBW)的可能危险因素,为进一步制定低出生体重相关干预政策与对策提供参考依据。方法采用病例对照研究的方法,通过上门访谈的方式进行流行病学问卷调查,使用SPSS18.0建立数据库并完成分析。结果通过单因素Logistic回归分析,发现本次怀孕胎数、母亲被动吸烟、蔬菜摄入频率、水果摄入频率、先兆早产、父亲被动吸烟、环境污染和饲养宠物8个因素与LBW的发生有联系(P<0.05)。将筛选出的8个危险因素作二分类变量Logistic回归分析,最终进入模型的变量为本次怀孕胎数、先兆早产和环境污染3个因素。结论 LBW的发生与孕妇的怀孕情况、行为习惯以及生活环境等多方面因素有关系,应采取针对性的措施有效降低LBW的发生。     

昆山市2001～2009年低出生体重儿流行病学分析

目的:描述昆山市2001～2009年9年间低出生体重(LBW)发生率,分析产妇及胎儿特征对低出生体重的影响。方法:利用昆山市《围产保健监测系统》研究33 631对产妇与胎儿,使用单因素与多因素无序多分类Logistic回归分析来估计各因素对出生体重的影响。结果:LBW发生率为1.86%。产妇超重肥胖、有人工流产史、男性胎儿可减小LBW发生风险。产妇体质指数偏低、初产妇、习惯性流产史可增加LBW发生风险。按照体质指数(BMI)分层,相对于LBW,BMI偏低组,高水平的孕期体重变化均可减小LBW胎儿发生风险。BMI正常组,高水平的孕期体重变化可减小LBW胎儿发生风险。没有发现在超重与肥胖组产妇孕期体重变化与分娩LBW胎儿之间存在统计学关联。结论:LBW发生率为1.86%,产妇与胎儿特征综合影响LBW。体重偏低与正常人群中,高水平的孕期体重变化可减小LBW发生风险。     

Utility of Population Attributable Fraction Assessment in Guiding Interventions to Reduce Low Birthweight in the High-Altitude State of Colorado

Objectives We evaluated the ability of population attributable fraction (PAF) assessments to alter significant modifiable risks for low birthweight (LBW) and the impact of high altitude as a risk for LBW in Colorado. Methods Logistic regression analysis of birth certificate parameters in 1995–1997 identified risk factors for PAF assessment. PAF for birth at high altitude, multiple births, and LBW in singleton births were determined. Subsequent analysis of singleton LBW risks, using number needed to treat (NNT) analysis, estimated how elimination of major modifiable risk factors could reduce LBW in the study population. Public health interventions were initiated and PAF analysis conducted 12 years afterward to determine the effect of interventions. Results PAF in singleton births revealed low maternal weight gain in pregnancy and maternal smoking as the greatest modifiable attributable risk factors for LBW (12.7/12.5 %, respectively, in 1995–1997 and 12.9/7.1 % in 2007–2009). Significant interaction between these variables resulted in PAF of 34.4 % when the two occurred together in 1995–1997, decreasing to 19.4 % in 2007–2009. NNT analysis of singleton births in 1995–1997 revealed that eliminating low maternal weight gain, smoking, late prenatal care in all women and interpregnancy intervals <1 year in multiparous women reduced LBW by 46.5 %. The respective proportional reductions in PAF of 40.3 and 46.3 % for maternal smoking and weight gain/smoking interaction were associated with a 1.4 % LBW reduction in singleton births between the two study periods. Conclusions for Practice PAF and NNT analyses are valuable tools to predict intervention targets to lower LBW.     

Factors associated with repetition of low birthweight: Missouri longitudinal study

The tendency to repeat low birthweight (LBW < 2500 g) was studied in 182 285 linked first and second birth Missouri livebirths for 1978–90, of which 10 701 had first birth LBW. We examined the likelihood of LBW repetition by first birth birthweight, preterm delivery, and small-for-gestational-age (SGA) status by race, and the odd ratios (ORs) of repeat LBW for risk factors such as smoking, in comparison with ORs of second birth LBW among women with normal-weight first births. We found a strong tendency to repeat LBW (21%), especially following more extreme LBW first births. Adjusted ORs for repeat LBW were 10.1 for births that were preterm and SGA; 7.9 for preterm non-SGA; and 6.3 for SGA term births. Significant ORs of LBW repetition were found for smoking (1.52 and 1.85 for smoking in second pregnancy only and both pregnancies, respectively), short interpregnancy interval (1.33), and advanced maternal age (1.17), but the ORs were generally lower than those for women with normal-weight first births. Low pre-pregnancy weight was a significant risk factor for LBW repetition.     

Parental cigarette smoking and the risk of spontaneous abortion.

Although cigarette smoking is often considered a risk factor for spontaneous abortion, the epidemiologic literature is actually inconsistent. Therefore, the authors examined maternal and paternal smoking and maternal passive smoke exposure using data from a large case-control study of spontaneous abortion (626 cases and 1,300 controls) conducted in Santa Clara County, California, in 1986 and 1987. No excess risk of spontaneous abortion was seen in the 1% of women who smoked an average of more than 20 cigarettes per day in the first trimester. Moderate smokers (11-20 cigarettes per day) had a slightly elevated crude odds ratio of 1.3 (95% confidence interval 0.9-1.9), which was close to unity after adjustment for covariates. Paternal smoking showed a slight crude elevation for moderate and heavy smoking, but no association after adjustment. In contrast, maternal exposure to environmental tobacco smoke for 1 hour or more per day was associated with spontaneous abortion, even after adjustment (odds ratio = 1.5, 95% confidence interval 1.2-1.9). For both maternal direct and environmental exposure, the association appeared to be stronger in second-trimester abortions. Several studies have found stronger associations of smoking with late versus early abortions, perhaps reflecting smoking-associated placental insufficiency and fetal hypoxia.