基于社区早孕和儿童免疫接种登记信息探讨女性孕前体质指数与新生儿出生体质量的关系

Association between Maternal Pre-pregnancy BMI and Neonatal Birth Weight:a Study Conducted in Women with Early Antenatal Registration and Their Infants Receiving Immunization Services in a Community Health Center

背景出生体质量影响母婴健康状况,其可能与女性孕前健康状况、体质指数(BMI)等因素相关。目的以上海市街道社区服务中心早孕登记信息和免疫接种登记信息为基础,了解上海市社区孕产妇健康状况和新生儿出生体质量情况并探讨女性孕前BMI与新生儿出生体质量的关系。方法本研究招录了2016年1—12月在上海市徐汇区华泾社区卫生服务中心早孕建卡的女性,且新生儿在该社区卫生服务中心注册进行儿童预防接种。根据该中心的早孕和儿童免疫接种登记信息,收集女性的一般资料(包括年龄、孕前BMI、孕次等)、新生儿一般资料(性别、出生体质量、胎龄等)。比较不同女性特征和新生儿特征的新生儿出生体质量,并采用Pearson相关分析和多元线性回归分析探讨女性孕前BMI与新生儿出生体质量的关系。结果不同性别、胎龄的新生儿出生体质量比较,差异有统计学意义(P<0.05);不同女性年龄、户籍地、孕次、孕前BMI的新生儿出生体质量比较,差异无统计学意义(P>0.05)。219例孕妇孕前平均BMI为(21.8±2.3)kg/m^2,新生儿平均出生体质量为(3 374.3±469.6)g。Pearson相关分析结果显示,女性孕前BMI与新生儿出生体质量无相关关系(r=0.072,P=0.290)。但上海户籍女性孕前BMI与新生儿出生体质量呈线性负相关(r=-0.273,P=0.007)。新生儿胎龄与其出生体质量呈线性正相关(r=0.485,P<0.001)。多元线性回归分析结果显示,新生儿性别、胎龄是出生体质量的影响因素(P<0.05)。结论本研究未发现女性孕前BMI与新生儿出生体质量相关,仅上海户籍女性孕前BMI与新生儿出生体质量呈线性负相关。

Background Neonatal birth weight influences the subsequent health of the infant and maternal postpartum health,which may be associated with maternal pre-pregnancy health and body mass index(BMI).Objective To investigate the status of maternal health and neonatal birth weight in community-based healthcare settings in Shanghai by reviewing early antenatal registration information and child's immunization information from a street community health center in Shanghai,and based on this,to examine the relationship between maternal pre-pregnancy BMI and neonatal birth weight.Methods We conducted this study in women and their infants recruited from Huajing Community Health Center(located Xuhui District in Shanghai)during January to December 2016.All the women received antenatal care after establishing an antenatal record card during early pregnancy and their infants received immunization services after establishing an immunization record card.We collected the general data of the women,such as age,pre-pregnancy BMI,gravidity,and the general data of their infants,including sex,birth weight,gestational age at birth and so on.Neonatal birth weight was analyzed by maternal and infant characteristics.Pearson correlation coefficient and multiple linear regression model were applied to estimate the relationship between maternal pre-pregnancy BMI and neonatal birth weight.Results The average pre-pregnancy BMI of the included 219 women was(21.8±2.3)kg/m2 and the average birth weight of their infants was(3 374.3±469.6)g.Neonatal birth weight differed significantly by sex and gestational age at birth(P<0.05),but did not by maternal age,place of hukou,gravidity,and pre-pregnancy BMI(P >0.05).Pearson correlation analysis showed that maternal pre-pregnancy BMI was not correlated with neonatal birth weight(r=-0.072,P=0.290)among the 219 mother-newborn pairs,but was negatively correlated with neonatal birth weight limited in Shanghai residents(r=-0.273,P=0.007).Gestational age at birth was positively correlated with neonatal birth weight(r=0.485,P<0.001).Sex and gestational age at birth of the infants were associated with neonatal birth weight by the multiple linear regression model(P<0.05).Conclusion No association between maternal pre-pregnancy BMI and neonatal birth weight was found in this study,but maternal pre-pregnancy BMI was negatively correlated with neonatal birth weight limited in Shanghai residents.