贫困农村地区低出生体重影响因素病例对照研究

A case-control study on the influential factors of low birth weight in rural areas

目的:了解贫困农村地区低出生体重发生率,分析其影响因素,为制定适宜的干预策略和措施提供科学依据。方法:2007年1～12月对云南省农村某贫困地区出生体重进行监测,并对其中170例低体重儿进行1∶2病例对照研究,采用单因素、多因素Logistic回归模型分析低出生体重影响因素。结果:①低出生体重发生率为7.97%,以宫内发育迟缓为主(67.84%)。②多因素Logistic逐步回归分析结果显示孕前一年患慢性病、孕期患慢性疾病和分娩地点为乡村医院、孕期有明显妊娠反应、孕期增重≤6.9kg、早产史是发生低出生体重的危险因素。③身高、孕期产检次数≥5次、婴儿胎龄足是低出生体重发生的保护因素。结论:祥云县贫困农村LBW发生率高于全国和全省平均水平。母亲孕前、孕期健康状况、孕期保健和营养状况是该地区低出生体重的主要影响因素。加强贫困农村地区的保健工作,开展适宜的孕期营养干预是减少低出生体重的重要保障。

Objective：To investigate the incidence of low birth weight （LBW） in rural areas of Yunnan province, to explore correlation factors of LBW, and to provide scientific basis for developing appropriate intervention strategies and measures for LBW.Methods：All new born were measured their birth weight and a 1∶2 case-control study for LBW was performed in 170 babies with LBW in rural areas of Yunnan province during the1st Jan to the 31st Dec, 2007. Simple and multivariate logistic regression models were used to identify the correlates of LBW.Results：①The incidence of low birth weight was 7.97%, and LBW was mainly attributed to intrauterine growth retardation（69.7%） in rural areas.②In multiple factors analysis, backward stepwise regression was used to fit the main effects of equation. The chronic diseases history before and during pregnancy, delivery site was township health centers, serious pregnancy reaction, body weight gain less than or equal to 6.9 kg during pregnancy, preterm delivery history were risk factors of LBW. ③Maternal height, prenatal examination over 5 times during pregnancy, and longer pregnancy duration were protective factors of LBW.Conclusion：The incidence of LBW in rural areas is higher than that of national and provincial average level. In this region, main correlates of LBW are maternal health status, maternal health care, and maternal nutritional status before and during pregnancy.The publicizing eugenic, health care and nutritional intervention during pregnancy, enhancing health care awareness of residents in poor rural areas, would surely relieve LBW burden in the area.