流动人口中发生巨大儿危险因素的成组病例对照研究

Risk factors for macrosomia in internal migrants:a grouped case-control study

目的:探讨导致流动人口中发生巨大儿的危险因素。方法:回顾分析上海市闵行区浦江镇流动人口特约分娩点足月分娩、产下新生儿体重≥4000g的503名非上海户籍健康产妇的住院病史资料,并选取相同时间段内分娩足月正常体重儿的健康产妇503名作为对照组,进行成组病例对照研究。本研究已排除糖耐量异常者。结果:多因素非条件Logistic分析显示,产妇的体质指数(BMI)(OR=4.057,95%CI:3.033～5.426)、产次(OR=3.136,95%CI:2.418～4.067)、经产妇前胎新生儿性别(OR=3.911,95%CI:2.645～5.783)及其体重(OR=4.395,95%CI:2.337～8.264)、产前检查次数(OR=1.213,95%CI:1.124～1.309)及夫妻间文化程度差异(OR=3.330,95%CI:2.191～5.057)均与流动人口孕妇产下巨大儿有关。结论:导致流动人口发生巨大儿的危险因素有一定的特殊性,其深层次原因仍有待进一步探讨。

Objective To investigate the risk factors of fetal macrosomia in pregnant women of migrant population. Methods Medical records of 503 healthy migrant women with birth of macrosomia baby （term birth, birth weight≥4000 g） were collected, and the control group included other 503 healthy migrant women delivering normal baby （term birth, birth weight 2 500-3 999 g）. Women with glucose intolerance were excluded. Results Unconditional multivariate Logistic analysis showed that maternal body mass index≥25（OR=4.057,95% CI：3.033-5.426）, parity≥2 （OR= 3.136, 95%CI：2.418-4.067）, gender （OR=3.911, 95%CI：2.645-5.783） and birth weight （OR=4.395, 95%CI：2.337-8.264） of newborn infant of previous birth, number of taken prenatal examination （OR=1.213, 95%CI：1.124-1.309） and educational difference between the spouse （OR=3.330, 95%CI：2.191-5.057） were correlated with the birth of macrosomia baby. Conclusions Besides pregnant obesity and maternal parity, several of the risk factors of fetal macrosomia occurrence in migrant women are unique, probably due to the specific socio-economic status of the population. Further studies are needed and relative interventions are proposed.