659例巨大儿危险因素1∶1配比病例对照研究

A case-control study on risk factors of 659 fetal macrosomia

目的探讨当前社会巨大儿发生的危险因素。方法对659例出生体重>4kg的巨大儿,按病例组和对照组1∶1配比方法,对总计1318户家庭进行了相关因素的调查和分析,所选儿童母亲为非糖尿病妊娠和非妊娠合并糖尿病患者。结果单因素和多因素条件Logist回归分析表明,最后3个月的饮食(偏回归系数1.541偏回归系数标准误=0.105,OR值=4.669)、祖辈的肥胖度(偏回归系数=3.148标准误0.532,OR值=23.292)、孕妇的职业(偏回归系数=0.454标准误=0.127OR值=1.575)、父亲的身高(偏回归系数=0.078标准误=0.22,OR值=1.081)和父亲的年龄(偏回归系数0.174标准误=0.52,OR值=11.090)与巨大儿发生相关,其中以饮食因素最为显著。结论巨大儿是多种因素造成的,环境因素中的多食已成为目前最主要的危险因素巨大儿的发生还与遗传因素和生活习惯关系密切。

Objective： To find out the risk factors of fetal macrosomia nowadays. Methods： Family background was surveyed and analyzed in 659 fetal macrosomia （birth weight 〉4kg） and a normal control group under 1：1 matching condition. Mothers with diabetes or pregnancy diabetes were not included in the assay. Results： Indicated by both simple and multiple conditional logouts regression, the cause of fetal macrosomia was mainly associated with the factors including caloric intake of mother within the last three months （βk =1.541, S.βk = 0. 105, βk = 4. 669）, obesity degree of parents （βk = 3. 148, S-xβk = 0. 532, βk = 23. 292 ）, mother＇s occupation （βk = 0. 454, S-xβk = 0. 127, βk=1.575）, body height offather （βk=0. 078, S-xβk =0.22, βk =1.081 ） and age offather （βk=0. 174, Sβk =0. 52, Sxβk =1.090 ） . Among them caloric intake was the most significant. Condusion： Multiple risk factors contribute to the occurrence of fetal macrosomia, among which motherg caloric intake has become the most important at present. In addition, genetic factor and life habits are closely involved in.