早产儿母亲生活方式疾病因素病例对照研究

A case-control study on life style and health status for mothers of preterm infants

目的对早产儿和足月儿母亲生活方式和疾病因素进行问卷调查,分析早产的相关危险因素,为降低早产发生率提供依据。方法选取严格配对的病例和对照共600例作为研究对象,对母亲进行生活方式、疾病因素和膳食(Knowledge-Attitude-Practice,KAP)等的问卷调查,对新生儿的一般资料进行收集,用条件logistic回归等进行统计分析。结果①早产儿母亲身高、孕前体重和孕前体重指数均低于足月儿母亲,早产儿出生身长、体重、Apgar评分总和均低于足月儿(P<0.05);②早产儿母亲的KAP以及总评分都明显低于足月儿母亲(P<0.05);尤其是早产儿母亲的膳食行为不合理、不科学尤其突出。③经多因素logistic回归分析发现早产的危险因素有反复流产病史和此次妊娠有胎膜早破;保护因素有母亲膳食KAP总评分和母亲孕前体重(P<0.05)。结论早产的高危人群为孕前体重低、营养知识态度行为评分低、有反复流产史及此次发生胎膜早破者。应强调定期产前检查,加强营养教育,在孕前和孕期尽量避免或消除以上危险因素。

Objective This study investigated the life style and health status of preterm and term infants＇ mothers in order to explore the risk factors for preterm delivery. Methods A total of 600 matched cases, including 120 pairs of preterm infants and their mothers and 180 pairs of term infants and their mothers were recruited. All of the mothers participated in a questionnaire survey on life style and health status during or before pregnancy. General data of the infants were also collected. Logistics regression analysis was used for evaluating the risk factors for preterm delivery. Results The height, body weights and body mass index before pregnancy in preterm infants＇ mothers were significantly lower than those in term infants＇ mothers （P 〈0.05）. The birth height and weights and Apgar scores in preterm infants were significantly lower than those in term infants （P 〈 0.05 ）. The whole nutritional Knowledge-Attitude-Practice （KAP） scores in preterm infants＇ mothers were significantly lower than those in term infants＇ mothers （P 〈 O. 05 ）. Muhiple factor regression analysis showed that recurrent abortions before gestation （ OR = 2. 332, P 〈 0.05 ） and premature rupture of membrane before delivery （OR =7. 979, P 〈 0.01 ） were risk factors for preterm delivery, while maternal nutritional KAP scores （OR = 0.949, P 〈 0.01 ） and body weights before pregnancy （ OR = 0.954, P 〈 0.05 ） were protective factors. Conclusions The women with low body weight, low nutritional KAP scores or recurrent abortions history before pregnancy or presenting premature rupture of membrane before delivery are at high risk for preterm delivery.