母亲身高与不良出生结局关联性分析

Associations of maternal height with adverse birth outcomes

目的探讨母亲身高与早产、低出生体重儿、巨大儿、小于胎龄儿的关系。方法收集2014年9月-2018年3月于广东省妇幼保健院分娩的11437名孕妇及其婴儿资料,根据母亲身高三分位数将研究对象分为3组(≤157.0、157.1~161.0以及>161.0 cm),采用多因素非条件logistic回归模型计算母亲身高与早产、低出生体重儿、巨大儿和小于胎龄儿的OR值及95%CI。结果研究对象中早产、低出生体重儿、巨大儿、小于胎龄儿的发生率分别为6.6%、6.3%、3.6%和16.5%。在控制可能的混杂因素后,结果显示母亲身高与早产、低出生体重儿、小于胎龄儿和巨大儿有统计学关联。母亲身高每增加1 cm,分娩低出生体重儿和小于胎龄儿的风险分别减少4.7%(OR=0.953,95%CI=0.939~0.968)和6.8%(OR=0.932,95%CI=0.922~0.942),分娩巨大儿的风险增加11.6%(OR=1.116,95%CI=1.094~1.139)。相对于身高≤157.0 cm组,身高>161.0 cm组分娩早产儿、低出生体重儿和小于胎龄儿的风险分别减少18.5%(OR=0.815,95%CI=0.677~0.980)、40.2%(OR=0.598,95%CI=0.492~0.726)和51.6%(OR=0.484,95%CI=0.426~0.551),而分娩巨大儿的风险增加207.0%(OR=3.070,95%CI=2.348~4.013)。结论身高较矮的孕妇分娩早产儿、低出生体重儿和小于胎龄儿的风险增加,身高较高的孕妇分娩巨大儿的风险增加。妇幼保健人员宜加强孕期监测,以减少早产儿、低出生体重儿、小于胎龄儿和巨大儿的发生风险。

Objective To investigate associations of maternal height with preterm birth,low birth weight,macrosomia and small gestational age.Methods Complete information on 11437 pregnant women registered for prenatal care in a provincial level women and children hospital and their babies born between September 2014 and March 2018 were extracted from the information system of Guangdong Provincial Maternal and Child Health Hospital and the pregnant women were divided into three groups according to their height in tertile distribution(≤157.0,157.1–161.0,and>161.0 centimeters[cm]).Non-conditional multivariate logistic regression model was used to calculate the odds ratios(OR)and their 95%confidence intervals(CI)for maternal height related risk of preterm birth,low birth weight,macrosomia and small gestational age of the newborns.Results The rate of preterm birth,low birth weight,macrosomia and small gestational age were 6.6%,6.3%,3.6%and 16.5%,respectively,among all the newborns.After adjustment for potential confounders,logistic regression results showed that maternal height was significantly associated with preterm birth,low birth weight,macrosomia and small gestational age.With every one cm increment in maternal height,the newborn′s risk of low birth weight and small gestational age decreased by 4.7%(odds ratio[OR]=0.953,95%confidence interval[95%CI]:0.939–0.968)and 6.8%(OR=0.932,95%CI:0.922–0.942),but the risk of macrosomia increased by 11.6%(OR=1.116,95%CI:1.094–1.139).Compared with the pregnant women with the body height≤157.0 cm,the risk of having a newborn of preterm birth,lower birth weight and small gestational age reduced by 18.5%(OR=0.815,95%CI:0.677–0.980),40.2%(OR=0.598,95%CI:0.492–0.726)and 51.6%(OR=0.484,95%CI:0.426–0.551),respectively,and the risk of having a macrosomia increased by 207.0%(OR=3.070,95%CI:2.348–4.013)among the pregnant women with the body height>161.0 cm.Conclusion The pregnant women with shorter stature are at a higher risk of having a preterm birth,low birth weight and small gestational age;while the taller pregnant women are at a higher risk for macrosomia.The results should be concerned in prenatal care to reduce the risk of the adverse birth outcomes.