早产儿和小于胎龄儿发生的危险因素的比较分析

Comparative analysis of risk factors for preterm and small-for-gestational-age births

目的 比较早产儿和小于胎龄儿发生的危险因素。方法 选择1 270例排除明确孕母疾病和产科危险因素的新生儿,自制调查问卷调查母亲身高、体重、被动吸烟和不良孕产史等因素,将研究对象分类为早产儿和足月儿、小于胎龄儿和适于胎龄儿,采用多因素logistic回归分析比较早产儿和小于胎龄儿发生的危险因素。结果 孕期增重〈9 kg使早产（OR=1.63,95%CI：1.12~2.07）和小于胎龄儿（OR=1.92,95%CI：1.56~2.58）发生的危险性均增高;母亲既往流产史（OR=1.46,95%CI：1.09~1.93）和早产史（OR=2.63,95%CI：1.81~3.92）是早产儿发生的的独立危险因素;孕母身高〈1.55 m（OR=2.46,95%CI：1.78~3.48）、孕前BMI〈18.5（OR=2.16,95%CI：1.53~3.16）、被动吸烟（OR=2.24,95%CI：1.65~2.98）是小于胎龄儿发生的的独立危险因素。结论 早产儿和小于胎龄儿的危险因素不同,针对两类特征孕妇应采取不同的预防措施,有针对性地减少两类不良妊娠结局的发生。

Objective To compare the risk factors between preterm and small-for-gestational-age （SGA） births. Methods A total of 1270 newborns who had no obstetric risk factors or maternal diseases were enrolled in this study. Their mothers＇ stature, body weight, passive smoking, and history of abnormal pregnancy were investigated using the self-designed questionnaire. The infants were divided into four groups： preterm, appropriate-for-gestational-age （AGA）, SGA, and term infants. Multivariate logistic regression analysis was performed to compare the risk factors between preterm and SGA births. Results A weight gain less than 9 kg during pregnancy increased the risks ofpreterm （0R=1.63, 95% CI： 1.12-2.07） and SGA （OR=1.92, 95% CI： 1.56-2.58）. The histories of abortion （OR=1.46, 95% CI： 1.09-1.93） and preterm birth （OR=2.63, 95% CI： 1.81-3.92） were independent risk factors for preterm births, while low pre- pregnancy body mass index （〈18.5） （OR=2.16, 95% CI： 1.53-3.16）, short stature （〈1.55 m） （OR=2.46, 95% CI： 1.78-3.48）, and passive smoking （OR=2.24, 95% CI： 1.65-2.98） were independent risk factors for SGA births. Conclusions Due to different risk factors between preterm and SGA births, specific preventive measures should be taken pertinently to reduce the incidence of the two bad pregnancy outcomes.