影响新生儿出生状况的多因素Logistic回归分析

The logistic regression analysis of the multiple factors that influence the neonatal birth conditions

目的 :研究多因素对新生儿出生状况的影响。方法 :采用回顾性队列研究方法对 14 0 5例产妇进行调查 ,在单因素 χ2 分析基础上进行非条件Logistic回归分析。结果 :对新生儿出生状况产生显著影响的因素共 8项 ,总判对力为 88.7% ,其中孕时年龄越大 ,巨大儿、新生儿窒息发生机会越多。孕期体重增长过速 ,巨大儿发生机会增大 ;相反则低出生体重儿 (LBW)、新生儿死亡机会增多。巨大儿母亲孕早期体重指数(BMI)显著高于其他组群。低体重儿有早产倾向。巨大儿的剖宫产率显著高于正常足月儿。职业为另一重要影响因素。按OR值大小 ,可将对新生儿出生状况产生影响的各因素按程度从强至弱依次排列为 :孕早期BMI、孕期体重增长、孕时年龄、分娩方式、妊娠结局、职业特点、孕周及胎盘重量。结论 :①孕时年龄偏大、孕早期BMI偏低而孕期体重增长过缓、或孕早期BMI偏高而孕期体重增长过速以及职业特点、孕周、胎盘重量是影响新生儿出生状况的危险因素。

Objective:To investigate the multiple factors affecting the neonatal birth condition.Methods:Through retrospective cohort study,1405 puerperal women were investigated by unlimited logistic regression based on single factor and χ 2 analysis.Results:There are eight significant factors affecting the neonatal birth conditions. The last correct class was 88.7%. With the increase of the age the risk of macrosomia and neonatal asphagsia in the pregnant woman was enhanced. The quick increase of the pregnant woman's weight resulted in the higher risk of macrosomia. Otherwise,chance of low birth weight(LBW) and neonatal death was greater. The mother's BMI of macrosomia was significantly higher than that of other groups,while LBW tend to have premature delivery. The caesarean risk in macrosomia group was significantly higher than that in normal group. Occupation was another important factor. According to their degree of influence on the birth conditions,all the factors were arranged in the order of OR value:BMI of first trimester, the whole increase of body weight during pregnancy,age of pregnancy,childbearing pattern,pregnant outcome,occupation,pregnancy weeks and weight of placenta.Conclusion:①The age,the low BMI of first trimester but slow weight increase in the pregnancy period,high BMI of first trimester but quick weight increase during pregnancy,occupation,pregnancy weeks and weight of placenta are risk factors affecting the neonatal birth condition.②Different neonatal birth condition,determine the childbearing pattern and pregnant outcome.