宫内发育迟缓影响因素的研究

目的 探讨宫内发育迟缓的影响因素。方法 采用整群抽样方法收集2008年4月至2011年3月湖南省浏阳市14个乡镇所有孕妇的孕产妇保健手册和分娩病历, 按照胎儿出生体重是否低于同孕龄胎儿体重的第10百分位数, 将6 105例单胎活产儿分为病例组和对照组, 采用单因素χ²检验和多因素非条件logistic回归分析胎儿宫内发育迟缓的影响因素。结果 共获得6 105例单胎妊娠的有效数据, 其中宫内发育迟缓528例(发生率为8.65%)。孕妇年龄<25岁(OR=1.268)、初产妇(OR=1.706)、初诊BMI<18.5 kg/m²(OR=1.709)、孕期体重增加不足(OR=1.576)以及患妊娠高血压综合征(OR=1.698)是宫内发育迟缓的危险因素。结论 孕妇年龄、产次、初诊BMI、孕期体重和妊娠高血压综合征与宫内发育迟缓有关。实时监测与控制体重及其变化, 加强妊娠高血压防治, 可能是预防宫内发育迟缓的重要措施。

Study on the determinants of intrauterine growth restriction

Objective To investigate the intrauterine growth retardation (IUGR) and its determinants so as to provide evidence for maternal and child health care programs to be carried out. Methods Fourteen townships were selected by cluster random sampling from 37 townships in Liuyang. A total of 6 105 pregnant women who had established their health care programs during April 2008 and March 2011, were recruited in this study. Records on pregnancy care manual and delivery were collected. 6 105 single live births were divided into two groups (IUGR group and control group). Those whose birth weight was below the 10th percentile for mean weight corrected for gestation age were grouped as IUGR group. Chi-square test and Multivariate logistic Regression method were used to estimate the determinants of IUGR. Results A total of 6 105 women, pregnant with a singleton gestation were enrolled in the study: 528 of these pregnancies were complicated with IUGR(8.65%). Data from the multivariate logistic regression analysis showed that maternal age less than 25(OR=1.268), prim parity(OR=1.706), BMI less than 18.5 kg/m² at first obstetrical examination(OR=1.709), deficiency in weight gain during pregnancy(OR=1.576) and pregnancy-induced hypertension syndrome(OR=1.698) were related risk factors to intrauterine growth retardation. Conclusion Maternal age, prim parity, BMI, weight gain during pregnancy and pregnancy-induced hypertension syndrome were factors associated to the intrauterine growth retardation. Effective measures in reducing the intrauterine growth retardation should include factors as monitoring maternal weight and the change of weight during pregnancy in order to maintain the weight at normal ranges. Prevention and therapy for pregnancy-induced hypertension syndrome, should also be strengthened.