山西省农村地区高出生体重危险因素研究

目的探索孕期环境因素和行为因素暴露与农村高出生体重(high birth weight,HBW)发生风险之间的关联。方法从2007-2012年期间山西省平定县出生人口及不良出生结局监测系统随访到204例对照、125例≥4 200 g HBW病例和171例4 000～4 200 g HBW病例。采用病例对照研究探索HBW风险因素。结果 2007-2012年期间,总出生数为18 749人,高出生体重1 177例,发生率为6. 28%。HBW <4 200 g组病例对照研究结果显示,调整了父母亲生育年龄、产次后,分娩孕周≥42孕周生育HBW的风险是<42孕周的3. 10倍(95%CI:1. 67～5. 76),生育男孩发生HBW风险是生育女孩的2. 30倍(95%CI:1. 46～3. 63),孕前BMI与HBW发生风险无统计学关联; HBW≥4 200 g组病例对照研究结果显示,调整了母亲生育年龄、产次后,分娩孕周≥42孕周生育HBW的风险是<42孕周的3. 01倍(95%CI:1. 49～6. 08),母亲孕前BMI≥24生育HBW的风险是BMI <24者的1. 91倍(95%CI:1. 15～3. 16),母亲孕期每周食用豆制品次数为4～7次,生育HBW的风险是每周食用豆制品次数≤1次者的2. 59倍(95%CI:1. 06～6. 32)。结论降低高出生体重的发生风险可从育龄人群的孕前体重、孕期饮食和分娩孕周管理入手。

Risk factors of high birth weight in rural areas of Shanxi Province

  Objective  To estimate the association between the risk of high birth weight(HBW) and maternal environmental and behavioral factors exposure during pregnancy in rural areas.  Methods  Data were collected from the surveillance system of birth population and adverse pregnancy outcome in Pingding County, Shanxi Province during 2007 and 2012, where we followed up 204 controls with normal birth weight, 125 cases with HBW ≥ 4 200 g and 171 cases with HBW 4 000-4 200 g. Case control study was performed to explore the potential risk factors of HBW.  Results  The total number of births was 18 749, including 1 177 cases of high birth weight, with an incidence rate of 6.28% between 2007 and 2012. Concerning the case control study on HBW<4 200 g, after adjusting parental reproductive age and parity, the risk of HBW was 3.10 (95% CI: 1.67-5.76) times higher among women with gestational weeks ≥ 42 than that of women with gestational weeks < 42. The risk of HBW in boys was 2.30 (95% CI: 1.46-3.63) times higher than that in girls. No significant association was observed between maternal BMI before pregnancy and the risk of HBW; Regarding the case control study on HBW ≥ 4200 g, after adjusting maternal reproductive age and parity, the risk of HBW was 3.01(95% CI: 1.49-6.08) times higher among women with gestational weeks ≥ 42 than that of those with gestational weeks <42. The risk of HBW was 1.91 (95% CI: 1.15-3.16) times higher among women with pre-pregnancy BMI ≥ 24 than that of those with pre-pregnancy BMI< 24. The risk of HBW was 2.59 (95% CI: 1.06-6.32) times higher in women who ate soybean products ≥ 4 times a week than that of those who ate soybean products less than once a week.  Conclusion  It would be of public health significance to reduce the risk of high birth weight, which can be reduced by managing pre-pregnancy BMI, diet during pregnancy and controlling gestational week.