基于二孩政策的活产儿出生顺序与早产及低出生体质量关系研究

Relationship between birth order of live neonates and premature and low birth weight: a cross-sectional study due to the twochild policy

目的：探讨活产儿出生顺序与早产及低出生体质量的关系,为提高人口出生质量提供参考。方法选取2013年在某市妇幼保健院分娩的所有单胎活产儿为研究对象,资料收集于新生儿出生医学信息登记系统。结果活产儿出生顺序在1～8之间（1．4±0．6）,出生顺序为1占65．9%（4055/6151）,出生顺序为2占29．8%（1835/6151）,出生顺序为3及以上占4．2%（261/6151）。出生顺序为1、2、3及以上的活产儿的早产检出率分别为8．2%、14．1%和27．2%（趋势χ^2=113．620, P〈0．05）,低出生体质量检出率分别为6．2%、11．1%和26．8%（趋势χ^2=132．228, P〈0．05）。控制产妇年龄、文化程度及户口所在地后多因素分析显示,出生顺序为2、3及以上的活产儿出现早产的危险性分别是出生顺序1的1．546倍和3．186倍,出现低出生体质量的危险性分别是出生顺序1的1．991倍和5．530倍。结论高出生顺序为早产及低出生体质量发生的高危因素。

Objective To explore the relationship between birth order and premature, low birth weight among live neonates in order to provide the basis for improving birth quality. Methods All live neonates of single birth were selected from this hospital in 2013, and the data were collected from Medical Birth Register. Results The number of birth order was 1～8 （1. 4 ± 0. 6）, the proportion of first birth or-der was 65. 9% （4 055/6 151）, second birth order was 29. 8% （1 835/6 151）, and third or more birth order was 4. 2% （261/6 151）. The prevalence rate of premature birth was 8. 2% in first birth order, 14. 1% in second birth and 27. 2% in third or more birth （χ^2 =113. 620, P〈0. 05）, and the prevalence rate of low birth weight was 6. 2 in first birth order, 11. 1% in second birth and 26. 8% in third or more birth （χ^2 =132. 228, P〈0. 05）. The factors of maternal age, educational level and residence were controlled and multivariate analysis showed that, the risk of premature of second （OR=1. 546, 95% CI：1. 305~1. 875）, third or more birth order （OR=3. 186, 95% CI：2. 342~4. 333） were significant higher than those of first birth order, and the risk of low birth weight of second （ OR=1. 991, 95% CI：1. 584~2. 502）, third or more birth order （OR=5. 530, 95% CI：3. 885~7. 870） were also significant higher than those of first birth or-der. Conclusion High birth order might be the risk factor of premature and low birth weight.