壮族地区孕前体质指数、孕期增重及孕期贫血对小于胎龄儿影响研究

目的 分析壮族地区小于胎龄儿（small for gestational age infants，SGA）发生情况，探讨孕妇孕前体质指数（body mass index，BMI）、孕期增重及孕期贫血等因素对发生SGA的影响，为更好地开展孕期保健指导提供依据。方法 选取2016年1~12月在广西平果县及隆安县的三家医院产科门诊首次产检、孕6~13周的2 199例单胎妊娠孕妇，收集孕妇的基本信息，并随访其产检记录、妊娠结局等信息。使用t检验、χ2检验和Logistic回归模型对调查数据进行分析。结果 SGA共327例，发生率为14.87%。调整混杂因素后，孕前BMI<18.5 kg/m2的孕妇比孕前BMI正常孕妇SGA发生风险增加1.09倍（OR=2.09，95%CI:1.59~2.75，P<0.001），孕期体重增加不足孕妇比增加正常孕妇SGA发生风险增加1.19倍（OR=2.19，95%CI:1.67~2.86，P<0.001），孕期轻、中重度贫血对SGA发生风险的影响差异均无统计学意义（均有P>0.05）。结论 孕前体质指数<18.5 kg/m2和孕期增重不足为该地区孕妇分娩SGA的危险因素。

Impact of maternal pre-pregnant body mass index,gestational weight gain and pregnant anemia on SGA in Zhuang Region

Objective To analyze the occurrence of small for gestational age infants (SGA) in Zhuang ethnicity region and the effects of pre-pregnant body mass index (BMI), gestational weight gain and pregnant anemia on SGA, to provide rationale to develop better health care for pregnant women. Methods A total of 2 199 pregnant women of single pregnancy were selected as the participants, who received the first prenatal examination during the first 6 to 13 weeks of gestation in Pingguo People's Hospital, Child Health Hospital and Long'an People's Hospital from January to December 2016, data of the general conditions of pregnant women, regular prenatal examination records, the pregnancy outcomes etc were collected. t-test, χ2 test and Logistic regression model were used for statistical analysis. Results A total of 327 infants were SGA, and the incidence of SGA was 14.87%. After adjusting the confounding factors, compared to the normal pre-pregnant BMI group, the pre-pregnant BMI <18.5 kg/m2 group showed increased risk of SGA (OR=2.09, 95% CI:1.59-2.75, P<0.001), compared to the normal gestational weight gain group, women with insufficient gestational weight gain had increased risk of SGA (OR=2.19, 95% CI:1.67-2.86, P<0.001) among their infants. There was no significant difference in the risk of pregnant anemia on SGA (all P> 0.05). Conclusion Pre-pregnant BMI<18.5 kg/m2, insufficient gestational weight gain are risk factors for SGA in Zhuang ethnicity region.