我国2006年至2008年巨大儿发生率调查及影响因素分析

目的了解我国新生儿出生体质量水平及巨大儿的发生率,探讨巨大儿发生的影响因素。方法采用整群随机抽样方法,自全国抽取了5个省份中的5个城市为研究现场,每个城市抽取一个或几个社区为城市人群,一个乡镇或自然村为农村人群。调查对象是自2006年1月1日至2008年12月31日出生的婴幼儿,有效人数为16 880。调查的主要内容有婴幼儿一般状况、父母一般情况、母亲孕产期健康状况、母亲流/引产情况等,用卡方和Logistic回归等方法进行统计分析。结果低出生体质量发生率为2.88%,巨大儿发生率为10.31%。男孩巨大儿发生率高于女孩（P〈0.01）,城市巨大儿发生率高于农村（P〈0.01）,5个地区的巨大儿发生率不同（P〈0.01）。单因素Logistic回归分析结果显示,婴儿性别、出生地区、母亲生育年龄、母亲文化程度、孕期疾病史、胎儿产期、引产史与巨大儿发生有关（P〈0.01或0.05）。多因素Logistic回归分析结果显示,男婴、城市出生、母亲生育年龄≥30岁、母亲文化程度高、胎儿过期产是巨大儿发生的危险因素（P〈0.01或0.05）。流产史和引产史与巨大儿发生无关（P〉0.05）。结论我国巨大儿发生率偏高,男性胎儿、城市人口、母亲生育年龄过大、母亲文化程度高、胎儿过期产会增加巨大儿发生的危险。

Incidence of Fetal Macrosomia and Influencing Factors in China from 2006 to 2008

Objective To explore the level of birth weight,incidence of fetal macrosomia and identify the influencing factors in China.Methods We used a random cluster sampling method to choose fields from five cities which stand for five regions in China,sampling one or more community to represent the urban population and one township or natural villege to represent the rural population in each city.Infants who were born from Jan 1,2006 to Dec 31,2008 were collected from these fields and the effective Sample size was 16 880.We surveyed face to face by designed questionnaires.Their parents were enrolled in our survey.The contents of investigation are as follows;general condition of infants and their parents, health condition in pregnancy in mothers,abortion and artificial labor in mothers.Chi-square and logistic regression were used in the study.Results Low birth weight rate was 2.88%,the incidence of fetal macrosomia was 10.31%.The incidence of fetal macrosomia in male was higher than that in female infants（P〈0.01） and in urban was higher than that in rural infants（P〈0.01）.The incidence of fetal macrosomia in five different areas was different（P〈0.01）.The results of univariate non-conditional Logistic regression suggested that the associated factors of macrosomia included gender of infants,region of infants,mother childbearing age,education of mum,diseases history during pregnancy,mature of birth and the history of induced labour.Multivariate conditional Logistic regression showed that the risk factors of macrosomia included male infants,urban infants,mother childbearing age≥30.education of mum and postmature birth.Conclusion Chinese infants appear to have increased incidence of fetal macrosomia. Male infants,urban infants,mother childbearing age≥30,higher education of mum,postmature birth would increase the risk of fetal macrosomia.