环境危险因素对太原市小于胎龄儿发生率的影响研究

Effects of environment risk factors on incidence of small for gestational age infants in Taiyuan

目的探讨环境相关危险因素与小于胎龄儿(简称SGA)之间的关系。方法采用公认的SGA的判别标准和太原市不同胎龄新生儿的出生体重分布,利用新生儿出生医学记录,确定太原市2005年11月—2012年期间出生的SGA,并对母亲发生SGA的相关影响因素进行分析。结果研究期间太原市SGA的发生率为7.91%(22 047/278 710),且呈现明显的下降趋势,男婴的SGA发生率高于女婴。单因素logistic回归分析显示,母亲孕期主、被动吸烟[RR=1.29(95%CI:1.08~1.56),RR=1.10(95%CI:1.01~1.20)]、饮酒[RR=1.22(95%CI:1.01~1.46)]以及其他不良因素暴露[RR=1.25(95%CI:1.00~1.56)]是SGA的危险因素。煤炉取暖、电取暖和做饭也是SGA发生的危险因素,用煤炉和电取暖的RR值分别为1.71(95%CI:1.65~1.78)和1.53(95%CI:1.35~1.73),用其做饭的RR值分别为1.32(95%CI:1.27~1.37)和1.33(95%CI:1.26~1.39)。厨房安装使用油烟机可以明显降低SGA的发生率(安装:6.53%;未安装:9.10%),RR值为0.70(95%CI:0.67~0.72)。控制了混杂因素以后,与城市集中供暖、用气体燃料做饭比较,家庭用电取暖[RR=1.18(95%CI:1.10~1.26)]或做饭[RR=1.08(95%CI:1.03~1.15)的母亲SGA发生率较高,具有统计学意义(P<0.05),厨房安装并使用抽油烟机的母亲SGA发生率较低[RR=0.91(95%CI:0.87~0.95)]。结论母亲孕期饮酒、主被动吸烟、其他有害因素暴露以及用煤和电作为取暖做饭能源是SGA的危险因素,改善家庭居住生活条件,建立良好的生活习惯可有效降低SGA的发生。

Objective To investigate the relationship between environment risk factors and small for gestational age(SGA)infants.Methods Based on the SGA standard and newborns birth records,the environment risk factors of SGA was investigated in Taiyuan during 2005-2012.Results The incidence of SGA infants was 7.91%(22 047/278 710) with a significant decrease.The boys' incidence of SGA was higher compared with girls.Single logistic regression analysis showed that smoking,passive smoking,drinking and contacted with the other risk factors during pregnancy were associated with SGA.The relative risk were 1.29(95%CI:1.08-1.56),1.10(95%CI:1.01-1.20),1.22(95%CI:1.01-1.46) and 1.25(95%CI:1.00-1.56),respectively.Coal and electricity as fuel,coal furnace and electric heater were also associated with SGA.The relative risk were1.32(95%CI:1.27-1.37),1.33(95% CI:1.26-1.39),1.71(95% CI:1.65-1.78) and 1.53(95% CI:1.35-1.73),respectively.After control for confounding factors,the independent risk factors for SGA only included electricity as fuel and electric heater and using kitchen ventilator,which would decline the incidence of SGA.Conclusion Smoking,drinking,passive smoking,contacting with the other risk factors and electricity as fuel and electric heater during pregnancy are the risk factors for SGA.The incidence of SGA can be effectively reduced through improve the living conditions and develop healthy living habits.