上海市闵行区巨大儿流行状况调查

Epidemiology survey of the macrosomia in Minhang area of Shanghai

目的:调查上海市闵行区巨大儿流行现状,分析其影响因素。方法:抽取上海市闵行区2家医院2013-2015年分娩的活产新生儿,以其中1 963例巨大儿为观察组;采用投掷硬币法随机选取同时段非巨大儿5 889例为对照组。比较2组孕妇产前一般情况、分娩方式以及并发症发生情况。结果:母亲妊娠期糖尿病、孕期体质量过增、孕前体质量指数过高、孕期饮食超量均是导致巨大儿的高危因素(P<0.01),观察组患儿的剖宫产率、产时窒息率和新生儿黄疸、先天性心脏病发生率亦均明显高于对照组(P<0.01)。结论:临床应重视巨大儿的产前诊断和管理,采取针对性的干预措施,以改善妊娠结局。

Objective：To investigate the epidemic situation of the macrosomia in Minhang area of Shanghai, and analyze its influencing factors. Methods：The neonates from two hospitals in Minhang area of Shanghai were investigated from 2013 to 2015, and the 1 963 macrosomias and 5 889 nonmacrosomias selected by casting coin at the same time were divided into the obseravtion group and control group, respectively. The prenatal general situation, mode of delivery and complications between two groups were compared. Results： The mother with gestational diabetes mellitus, gestational overweight, prepregnancy BMI overhigh and diet control during pregnancy were the high risk factors of macrosomia（P 〈 0.01 ）. The rates of cesarean section, intrapartum asphyxia, and the incidence rates of neonatal jaundice and congenital heart disease of macrosomias in observation group were significantly higher than those in control group（P 〈 0. 01 ）. Conclusions ：The prenatal diagnosis and management of macrosomia should be paid attention to. Selecting the appropriate mode of delivery can improve the pregnancy outcome.