陕西省妇女既往生育史与末次妊娠巨大儿的相关性分析

Correlation analysis between the past pregnant history of women and macrosomia in the last pregnancy in Shaanxi Province

目的利用"陕西省出生缺陷现况及其危险因素调查"数据探索陕西省单胎活产新生儿巨大儿发生率与母亲既往生育史的相关性。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年陕西省怀孕且出生体重明确的育龄妇女生育史等相关信息。采用Logistic回归借助SPSS 18.0对数据进行分析。结果活产单胎新生儿巨大儿发生率为6.85%,接近全国平均水平。经多因素Logistic回归逐步法按α入=0.05、α出=0.1筛选出:人工流产史(OR=1.33,95%CI:1.13-1.57)、葡萄胎史(OR=4.74,95%CI:1.27-17.72)、巨大儿史(OR=4.21,95%CI:3.39-5.23)、母亲末次妊娠年龄>34岁(与15～24岁相比OR=1.26,95%CI:1.05-1.52)是发生巨大儿的危险因素。过期产史(OR=0.46,95%CI:0.28-0.72)、母亲末次妊娠年龄24～29岁(与15～24岁相比OR=0.76,95%CI:0.63-0.91)、女婴(相对于男婴OR=0.55,95%CI:0.50-0.61)是巨大儿的保护因素。结论研究显示人工流产史、葡萄胎史、巨大儿史、母亲末次妊娠年龄过大是发生巨大儿的危险因素。过期产史、母亲末次妊娠年龄适宜、女婴是巨大儿的保护因素。

Objective To explore the correlation between the past pregnant history of women and macrosomia incidence of singlebirth infants in Shaanxi Province using the data from the ‘ Investigation on the Status of Birth Defects and Their Risk Factors in Shaanxi Province＇. Methods The stratified multistage random sampling method and questionnaire survey we e used to collect information about the fertility history of pregnant women who were in pregnancy,and had definite birth weight from 2010 to 2013 in Shaanxi Province. Logistic regression was used to analyze the data with SPSS 18. 0. Results In this study, the 15 ~49 years old ＂women of childbearing age and children were investigated,excluding twins, stillbirth, birth weight unknown, 27 693 live born singleton newborns met the conditions,the incidence of macrosomia was 6. 85%,close to the national average. The stepw-ise Logistic method with alpha into =0. 05, alpha out = 0. 1 w,as used to screen variable：the history of artificial abortion,（ Ofi = 1. 33,95% CI： 1. 13 - 1. 57）,the history of hydatidiform mole（ Ofi =4. 74,95%CI：1. 27 -17. 72）,the history of macrosomia（ Ofi =4. 21, 95%CI：3. 39 - 5 . 2 3 ,maternal last gestational age 〉34 years old（Compared ＂with 15 ~24 years old Ofi = 1. 26,95%CI：1. 05 -1. 52）＊were risk factors for macrosomia, while expired birth history（ Ofi =0. 46,95%CI：0. 28 -0. 72）、maternal last gestational age 24 ~29 years old（Compared with 15 ~24 years old Ofi =0. 76,95%CI：0. 63 -0. 91）、baby girl（ Relative to baby boys Ofi =0. 5 5,95%C I ：0. 50 - 0 . 61） were protective factors for macrosomia. Conclusion This study demonstrated that the history of artificial abortion,history of hydatidiform mole,history of macrosomia,mother of the last pregnancy of old age were the risk factors of macrosomia.,while expired birth historysmother＇s last pregnancy with appropriate age,the baby girl were the protective factors of macrosomia.