陕西省活产单胎新生儿低出生体重现况及其影响因素分析

Incidence of low birth weight among single live birth neonates and influencing factors in Shaanxi

目的 分析陕西省活产单胎新生儿低出生体重（LBW）发生率及其影响因素.方法 采用分层多阶段随机抽样方法,以问卷调查方式收集2010-2013年陕西省怀孕且怀孕结局明确的育龄妇女及其子女的相关信息.结果 共调查28 164名育龄妇女及其子女,活产单胎新生儿LBW发生率为3.4％.其中2010-2013年LBW发生率分别为4.1％、4.4％、3.1％和2.6％,陕南、陕北和关中地区LBW发生率分别为3.8％、3.4％和3.2％,城乡LBW发生率分别为2.5％和3.6％,早产和足月产中LBW发生率分别为32.0％和2.6％.logistic回归分析显示,女婴（OR=1.57,95％CI：1.36 ～ 1.81）、早产（OR=18.28,95％CI：15.23 ～ 21.96）、母亲文化程度低（OR=1.27,95％CI：1.06～1.52）、产检次数＜4次（与产检4～7次比较,OR=1.36,95％CI： 1.14～ 1.63）、产检次数≥8次（与产检4～7次比较,OR=1.84,95％CI： 1.48 ～ 2.29）、妊娠高血压综合征（OR=3.07,95％CI：2.12 ～4.43）、经产妇（OR=1.21,95％CI：1.03 ～ 1.41）、围孕期未服用叶酸（OR=1.30,95％CI：1.12～1.52）是发生LBW的危险因素.结论 2010-2013年陕西省活产单胎新生儿LBW发生率低于全国平均水平,且呈下降趋势,但农村地区高于城市.女婴、早产、母亲文化程度低、产检次数不规范、妊娠高血压综合征、经产妇、围孕期未服用叶酸等有可能增加LBW罹患风险.

Objective To analyze the incidence of low birth weight among single live birth neonates and identify the influencing factors in Shaanxi province.Methods A questionnaire survey was conducted among the childbearing aged women selected through multi stage stratified random sampling in Shaanxi during 2010-2013, all of these childbearing aged women were in pregnancy or had definite pregnancy outcomes.Results A total of 28 164 childbearing aged women and their infants were investigated.The overall incidence of low birth weight among the single live birth neonates surveyed was 3.4% during 2010-2013 （4.1% in 2010, 4.4% in 2011,3.1% in 2012, 2.6% in 2013, respectively）.The incidence of the low birth weight was 3.8% in southern Shaanxi, 3.4% in northem Shaanxi and 3.2% in central area of Shaanxi.The incidence of the low birth weight was 2.5% in urban area and 3.6% in rural area.Compared with the low birth weight incidence of 2.6% in full-term infant, the low birth weight incidence was 32.0% in preterm infants.The results of logistic regression analysis suggested that being female infant （OR=1.57, 95% CI： 1.36-1.81） , preterm delivery （OR =18.28, 95% CI： 15.23-21.96）, lower educational level of mothers （OR =1.27, 95% CI：1.06-1.52）, antenatal care times 〈4 （compared with 4-7,OR=1.36, 95%CI： 1.14-1.63） ,antenatal care times ≥8 （compared with 4-7, OR=1.84, 95% Ch 1.48-2.29）, gestational hypertension （OR=3.07, 95% CI： 2.12-4.43） , being multipara （OR=1.21,95% CI： 1.03-1.41） , taking no folic acid during pregnancy （OR=1.30, 95% CI： 1.12-1.52） were risk factors for the low birth weight of neonate.Conclusion The incidence of low birth weight among single live birth neonates was in decline in Shaanxi.The incidence of the low birth weight was higher in rural area than in urban area.The incidence of the low birth weight was lower than national level.Being female neonate, preterm delivery, lower education level of mothers, irregular antenatal care, gestational hypertension, being multipara, taking no folic acid during pregnancy were the risk factors for low birth weight of neonates.