孕妇生理心理与孕期保健对低出生体重儿的影响

Study on the influence of maternal physiology, mentality and prenatal health care on children born with low birth weight

目的 探讨孕妇生理心理与孕期保健对低出生体重儿（LBW）的影响。方法 采用回顾性LBW-小于胎龄儿（SGA）-对照（正常）三组病例对照研究方法，对2004年11月至2006年6月在福建省妇幼保健院住院分娩的婴儿及产妇，于产后对896例的产妇进行问卷调查和摘取病历相关资料。将所得变量采用x^2检验进行单因素分析，再将有意义的变量入选logistic回归多因素分析。结果 2个变量因素中有统计学意义的单因素有15个，包括孕妇心理因素2个、生理因素4个、病理因素6个、孕期保健因素3个。经logistic回归多因素分析结果显示孕妇身高、产检次数、无应激试验异常、脐带绕颈、脐血流阻力异常、初检孕周、胎膜早破、孕妇对婴儿性别的企盼、异常家族史等9个因素是LBW的主要影响因素，健康教育知识获取与否是保护因素，说明有些LBW可以在孕期预防。结论 LBW的发生是多种因素综合作用的结果。

Objective To explore the role of maternal physiology,mentality and prenatal health care on low birth weight （LBW）. Methods A LBW-small for gestation age （SGA）-control group retrospective study was conducted based upon a population of infants born from November 2004 to June 2006. 896 cases involved in this study were entirely under voluntary participation and subject could withdraw their consent at any point. All subject recruitment and enrollment took place at Fujian Provincial Maternal and Children Hospital at the time of delivery. Using X^2 test for single factor analysis and logistic regression for multiple analyses Results There were 15 out of 22 single factors having statistical significances, including 2 maternal psychological, 4 physiological, 6 pathological and 3 prenatal health care factors respectively. When multi-factorial stepwise regression analyses was performed, there were 9 factors for main relative factors of LBW,including women＇s height ,number of prenatal examination, in-normal non-stress test, umbilical cord around the neck, retardation of the umbilical blood flow, week of gestation when the first examination was performed, premature rupture of membrane, preference on the sex of the infant, abnormal family history etc. were influencing the existence of LBW. Awareness on health information appeared to be a protective factor, suggesting that LBW could be prevented during the pregnant period. Conclusion Multiple factors seemed to be contributing to the incidence of low birth weight.