母亲文化程度与产前检查次数对新生儿低出生体重的影响及其交互调节作用

Modifying effect of maternal education level on association between the number of prenatal care visits and neonatal low birth weight

目的研究母亲文化程度与产前检查次数对新生儿低出生体重(LBW)的影响及其交互调节作用。方法利用陕西省出生缺陷现况及其危险因素调查中有关育龄妇女及其生育子女的相关信息,采用非条件Logistic回归分析母亲产前检查次数与文化程度对新生儿发生LBW的相乘交互作用,并采用Andersson等编制的软件分析它们之间的相加交互作用。结果随着产前检查次数的增多,全部新生儿与足月儿LBW和小于胎龄儿(SGA)的发生率逐渐降低。母亲文化程度为高中及以上全部新生儿(OR=0.81,95%CI:0.65～1.00)、足月产新生儿LBW(OR=0.76,95%CI 0.60～0.97)相比母亲文化程度初中及以下分组,以及SGA(OR=0.86,95%CI 0.77～0.95)的发生风险降低;较多的产前检查次数均可减少全部新生儿、足月产新生儿LBW及SGA的发生风险。母亲文化程度与产前检查次数对全部新生儿(RERI=0.091,API=0.152,SI=0.815)、足月产新生儿LBW(RERI=0.022,API=0.039,SI=0.951)及SGA(RERI=0.091,API=0.152,SI=0.815)均不存在相加交互作用,但对全部新生儿(OR=0.78,95%CI:0.63～0.97)、足月产新生儿LBW(OR=0.72,95%CI:1.11～1.25)及SGA(OR=0.84,95%CI:0.76～0.94)均存在相乘交互作用,且作用相当。结论母亲文化程度低和产前检查次数较少均是新生儿LBW发生的危险因素,且母亲文化程度在产前检查次数对新生儿LBW的影响中存在调节作用,即较高的文化程度可以改善低产检次数对新生儿LBW的作用。

Objective To investigate the modifying effect of maternal education level on the association between the number of prenatal care visits and neonatal low birth weight(LBW).Methods The information about women of childbearing age and their children was obtained through a survey on the status of birth defects and their risk factors in Shaanxi Province.Logistic regression model was used to explore the multiplied interaction between maternal education level or the number of prenatal care visits and neonatal low birth weight and the Excel table prepared by Andresson et al.was used to calculate the adding interaction.Results With the increase of the number of prenatal care visits,the incidence of LBW and SGA in all the newborns and full-term infants gradually decreased.When the mother s education level was high school and above,the risk of incidence of LBW(OR=0.81,95%CI 0.65-1.00)and SGA(OR=0.86,95%CI 0.77-0.95)in all the newborns and full-term infants(OR=0.76,95%CI 0.60-0.97)were reduced.Also there was a reduced risk of LBW and SGA in all the newborns and full-term infants with increased times of prenatal care visits.Interaction analysis showed that the level of maternal education and the number of prenatal care visits only had multiplied interaction on LBW(OR=0.78,95%CI:0.63-0.97)and SGA(OR=0.84,95%CI:0.76-0.94)in all the newborns and full-term infants(OR=0.72,95%CI:1.11-1.25).Conclusion The lower education level of the mother and fewer antenatal care visits were the risk factors for the occurrence of neonatal LBW,and the level of maternal education had a modifying effect on the influence of prenatal examination on neonatal LBW.Higher maternal education can improve the effect of fewer prenatal care visits on neonates'LBW.