母亲孕期生活习惯与低出生体重关系病例对照研究

Effect of maternal lifestyle on low birth weight: a case-control study

目的 探讨母亲孕期生活习惯与早产低体重和足月低体重的关系。方法 运用整群抽样方法,采用自编孕期健康调查问卷对2015年8月—2016年5月在广东省江门市14家医院住院分娩的1 964名产妇及其新生儿进行调查,应用二水平logistic回归模型进行多因素分析。结果 早产低体重组、足月低体重组和正常体重组分别为294、289和1 381名;3组被动吸烟率分别为36.39%、38.41%和33.09%,饮酒率分别为2.72%、3.11%和1.59%。在调整了其他因素后,与母亲孕期基本不锻炼相比,孕期体育锻炼1-3次/周（AOR=0.58,95%CI=0.40-0.86）和≥4次/周（AOR=0.54,95%CI=0.37-0.78）均是早产低体重的保护因素;在足月低体重儿中,与母亲孕期平均每天使用电子设备时长〈1 h相比,使用1-2 h（AOR=0.61,95%CI=0.40-0.93）、3-4 h（AOR=0.55,95%CI=0.35-0.86）和〉4 h（AOR=0.57,95%CI=0.37-0.89）的母亲其新生儿发生低体重的危险均降低;母亲孕期被动吸烟（AOR=1.36,95%CI=1.02-1.81）是足月低体重的危险因素。结论 母亲孕期生活习惯会影响低体重儿的发生,且在早产低体重儿和足月低体重儿中存在差异,应采取相应的干预措施降低低体重儿的发生。

Objective To investigate the association between maternal lifestyle and preterm low birth weight （PLBW） and term low birth weight （TLBW）. Methods Using cluster sampling, 14 hospitals in Jiangmen city were selected and 1964 pregnant women giving live birth to their singletons in these hospitals from August 2015 to May 2016 were surveyed with self-designed questionnaires. Two level logistic regression analysis was used in data analysis. Results The number of participants in the group of PLBW （ giving the birth of a singleton with the birth weight of 〈 2 500 grams at 〈37 gestational weeks）, TLBW （with full-term singleton with birth weight of 〈 2 500 grams） and controls （hospital- and birth time-matched and with live singleton of ≥2 500 grams birth weight） were 294,289 and 1 381, respectively. Among the pregnant women of the three groups, the prevalence of passive smoking were 36. 39 %, 38.41%, and 33.09% and the prevalence of alcohol drinking were 2. 72% ,3.11% ,and 1.59% ,respectively. After adjusting for other confounders, doing physical exercise 1 - 3 times/week（ adjusted odds ratio [ AOR ] = 0. 58,95 % confidence interval[ CI] =0. 40 -0. 86） and more than 4 times/week （AOR =0. 54,95% CI =0. 37 -0.78） during pregnancy were protec- tive factors of PLBW compared with not doing exercise during pregnancy;using electronic equipment like mobile phone, computer,or television 1 -2 hours/day （AOR =0. 61,95% CI=0. 40 -0. 93） ,3 -4 hours/day （AOR =0. 55,95% CI = 0. 35 - 0. 86）, and more than 4 hours/day （AOR = 0. 57,95 % CI = 0. 37 - 0. 89 ） showed protective effect on TLBW when compared with using the equipments less than 1 hour/day. Passive smoking during pregnancy increased the risk of TLBW （AOR = 1.36,95 % CI = 1.02 - 1.81 ）. Conclusion Maternal lifestyle during pregnancy may play a role in the occurrence of infant low birth weight and the role is different for PLBW and TLBW. The results suggest targeted interventions are needed to decrease the prevalence of infant low birth weight.