妊高征与小于胎龄儿的相关性研究

目的:探讨妊高征与小于胎龄儿(SGA)之间的联系。方法:选取2000年1月~2004年10月在本院出生的单胎活产SGA病例共834例(男443例,女391例)作为病例组。以胎儿性别及出生孕周进行频数匹配,按1∶3的比例,采用完全随机抽样方法选取出生体重在10%~90%分位的适于胎龄儿2 502例(男1 329例,女1 173例)为对照组,比较病例组及对照组新生儿母亲孕期患妊高征的比例。结果:①病例组母亲患轻度、中度及重度妊高征比例分别是对照组的2.52(95%C I,1.35~4.69)、4.21(2.03~8.70)和5.15(3.10~8.54)倍;②分层分析表明,男性及女性病例组母亲妊高征的患病比例分别是对照组的4.45(2.72~7.27)和3.51(2.14~5.75)倍,男性及女性病例组母亲妊高征的患病优势比无显著差异,早产和足月病例组母亲患妊高征的比例分别为对照组的9.96(4.50~22.02)和3.21(2.15~4.78)倍,早产病例组母亲妊高征的患病优势比显著高于足月病例组;③校正性别、足月与否及母亲年龄的多因素分析结果与单因素分析结果类似。结论:妊高征可显著增加SGA发病的危险性。

A case - control study of the association between gestational hypertension and risk of small for gestational age

Objective:The association between pregnancy-induced hypertension(PIH) and risk of small for gestational age(SGA) infant was assessed.Methods:SGA group included 834(443 males and 391 females) singleton alive SGA deliveries in our hospital during January 2000 to October 2004.2502(1 329 males and 1 173 females) appropriate for gestational age(AGA) infants(1∶3,SGA/AGA) matched by gender-and gestational-age-stratified frequencies of SGA were randomly selected for the controls from the infants with birth-weights ranged 10 th~90 th percentiles.Ratios of maternal PIH between the case and control groups were compared.SGA was defined as sex-specific birthweight for gestational age that was equal to or less than 10th percentile cut-off of fetal growth reference of singleton alive infants delivered in our hospital during the period.Results:Univariate analysis showed that the ratios of mild,moderate and severe maternal PIH in the SGA group was 2.52(95%CI,1.35~4.69),4.21(2.03~8.70) & 5.15(3.10~8.54) folds higher than in the AGA group.The odds ratios(95%CI) for PIH in male and female infants were 4.45(2.72~7.27) & 3.51(2.14~5.75),and in preterm and term sub-groups were 9.96(4.50~22.02) & 3.21(2.15~4.78),respectively.In the multivariate logistic analysis,such associations changed little after adjusting for maternal age,gestational age and infant's sex.Conclusion:The findings showed that PIH significantly increased the risk of SGA in a dose-dependent manner.