高龄二孩生育对新生儿异常出生体重的影响

Effect of second-child fertility of advanced age on neonatal abnormal birth weight

目的探讨高龄二孩生育对新生儿异常出生体重的影响,为二孩政策下的优生优育提供依据。方法选取2015年江苏省某三甲医院出生的2 479名活产单胎新生儿,通过单因素分析和多元Logistic回归分析探讨高龄二孩生育对低出生体重儿和巨大儿发生率的影响。结果适龄产妇和高龄产妇分娩低出生体重儿和巨大儿发生率比较差异均无统计学意义(均P>0.05)。分层分析结果显示农村地区高龄产妇分娩低出生体重儿发生率高于适龄产妇(P<0.05)。初产妇和经产妇分娩低出生体重儿和巨大儿发生率比较差异均无统计学意义(均P>0.05)。分层分析结果显示孕前BMI正常的初产妇低出生体重儿发生率高于经产妇(P<0.05),农村地区的初产妇分娩低出生体重儿发生率高于经产妇(P<0.05),孕前偏瘦的经产妇分娩巨大儿发生率高于初产妇(P<0.05)。多因素Logistic回归分析显示高龄对异常出生体重的影响无统计学意义(OR=1.393,95%CI:0.535~3.629;OR=0.925,95%CI:0.498~1.720);经产妇分娩低出生体重儿的风险比初产妇下降了近50%(OR=0.519,95%CI:0.276~0.978),经产妇分娩巨大儿的发生率有上升趋势(OR=1.221,95%CI:0.836~1.784)。结论高龄可能会增加低出生体重儿和巨大儿的发生风险,女性应避免高龄生育;二孩生育的妇女应警惕巨大儿的发生。

Objective To explore the effect of second-child fertility of advanced age on neonatal abnormal birth weight,provide a basis for eugenics under the two-child policy. Methods A total of 2 479 single live births born in a Grade Ⅲ Level A hospital in Jiangsu in2015 were selected,univariate analysis and multivariate logistic regression analysis were used to explore the effect of second-child fertility of advanced age on incidence rates of low birth weight infants and giant infants. Results There was no statistically significant difference in the incidence rates of low birth weight infants and giant infants between pregnant women of the right age and pregnant women of advanced age（ P〈0. 05）. Stratification analysis showed that the incidence rate of low birth weight infants born by pregnant women of advanced age was statistically significantly higher than that born by pregnant women of the right age in rural area（ P〈0. 05）. There was no statistically significant difference in the incidence rates of low birth weight infants and giant infants between primiparous women and multiparous women（ P〈0. 05）. Stratification analysis showed that the incidence rate of low birth weight infants born by primiparous women with normal progestational BMI was statistically significantly higher than that born by multiparous women（ P〈0. 05）,the incidence rate of low birth weight infants born by primiparous women in rural area was statistically significantly higher than that born by multiparous women（ P〈0. 05）,the incidence rate of giant infants born by multiparous women who were thin before pregnancy was statistically significantly higher than that born by primiparous women（ P〈0. 05）. Multivariate logistic regression analysis showed that advanced age had no significant impact on abnormal birth weight（ OR = 1. 393,95% CI： 0. 535-3. 629; OR = 0. 925,95% CI： 0. 498-1. 720）,the risk of low birth weight infants born by multiparous women was lower than that born by primiparous women by nearly 50%（ OR = 0. 519,95% CI： 0. 276-0. 978）,the incidence rate of giant infants born by multiparous women showed an increasing trend（ OR = 1. 221,95% CI： 0. 836-1. 784）. Conclusion Advanced age may increase the risks of low birth weight infants and giant infants,advanced fertility age should be avoided,the risk of giant infants should be alerted among women of second-child fertility.