父亲因素与低出生体重儿发生的相关性分析

Correlation analysis between paternal factors and low birth weight infant

目的探讨父亲因素对活产低出生体重儿发生的影响。方法选取2017年2月至2018年12月在甘肃省妇幼保健院产科住院分娩的新生儿5311例为研究对象,按出生体重分为低出生体重组(332例)和正常出生体重组(4979例)。使用耶鲁大学制定的《孕妇健康调查问卷》对孕妇进行调查。收集新生儿父亲及产妇的一般资料并计算体重指数(body weight index,BMI),收集孕妇孕期健康状况、产时资料、新生儿情况等。计数资料率的比较采用χ^(2)检验,分别用单因素和多因素Logistic回归分析各种因素与低出生体重的关联强度OR和调整OR(aOR)。结果①低出生体重组和正常出生体重组在母亲民族、孕前体重、孕前BMI、母亲孕期主动吸烟史方面比较,差异无统计学意义(P值均>0.05)。②单因素分析发现父亲年龄≤20岁、21~25岁、≥40岁年龄时低出生体重发生的可能性更高。父亲身高>175 cm、体重>75 kg、BMI 24.0~27.9 kg/m^(2)是低出生体重的保护性因素。父亲身高≤165 cm,体重≤60 kg,BMI<18.5 kg/m^(2),在孕前、孕早、孕中期、孕晚期吸烟是低出生体重发生的危险因素。③多因素Logistic回归分析发现,父亲年龄≤20岁是低出生体重的独立危险因素(aOR=7.183,95%CI:1.842~28.002)。父亲的教育水平在小学及以下组发生低出生体重的风险最高(aOR=3.462,95%CI:1.652~7.256),并随着父亲教育水平的增高,发生低出生体重的风险降低(趋势检验P=0.002)。父亲的身高≤165 cm是低出生体重发生的危险因素(aOR=1.843,95%CI:1.107~3.069)。父亲的BMI<18.5 kg/m^(2)亦是低出生体重发生的危险因素(aOR=2.494,95%CI:1.299~4.788)。父亲于孕前、孕早期、中期、晚期在孕妇面前吸烟在本次研究的人群中未发现是低出生体重发生的独立危险因素。结论孕期保健不仅要关注母亲,也要加强父亲的健康教育,提高育龄夫妇自我保健意识及父亲良好的生活行为方式,可有效降低低出生体重的发生。

Objective To investigate the associations between paternal factors and low birth weight(LBW).Methods A case-control study included 332 LBW infants and 4979 normal birthweight infants who were delivered at Gansu Provincial Maternity and Child-care Hospital between February 2017 and December 2018.Pregnant women were surveyed using the Pregnant Health Questionnaire developed by Yale University.General data of the parents were collected and body mass index(BMI)was calculated.Health status of pregnant women during pregnancy,information on delivery and neonatal conditions were collected.The chi square test was used for comparison of counting data rates.Univariate and multivariate logistic regression were used to analyze the correlation strength OR(univariate analysis)and adjusted OR(aOR)between various factors and LBW infants.Results①There were no significant differences between the low birth weight group and the normal birth weight group in maternal ethnicity,pre-pregnancy weight,pre-pregnancy BMI,and maternal smoking history during pregnancy(P>0.05).②Univariate analysis showed that fathers≤20 years old,21-25 years old,≥40 years old were more likely to have LBW in their children.The paternal height>175 cm,body weight>75 kg,and BMI 24-27.9 kg/m^(2) were protective factors for LBW.The father height≤165cm,weight≤60 kg,BMI<18.5 kg/m^(2) and smoking before pregnancy,early pregnancy and second trimester,third trimester were the risk factors of LBW.③Multivariate logistic regression analysis showed that the father's age≤20 years old(aOR=7.183,95% CI:1.842-28.002),the father's education level was high school or below(P<0.05),the father's height≤165 cm(aOR=1.843,95%CI:1.107-3.069)and father's BMI<18.5 kg/m2(aOR=2.494,95% CI:1.299-4.788)were independent risk factors for the occurrence of LBW.Fatherly smoking in the presence of pregnant women before,in the first,second,and third trimesters was not found to be an independent risk factor for low birth weight in the study population.Conclusion In pregnancy health care,we should not only pay attention to the mother,but also strengthen the father's health education.Raising the childbearing age couple's self-health awareness and father's good life behavior can effectively reduce the occurrence of low birth weight.