2019年北京市延庆区早产发生状况及危险因素分析

Analysis of status of premature birth and risk factors in Yanqing District of Beijing 2019

目的探讨孕妇发生早产的高危因素,为预防早产的发生制定干预措施及政策提供理论依据。方法选取在北京市延庆区所属社区卫生服务中心建立《母子健康档案》且于2019年1月1日至12月31日分娩的产妇作为研究对象,最终共纳入3746例产妇和3806例活产儿。本次研究内容主要包括孕产妇的年龄、文化程度、身体质量指数、是否服用叶酸、孕检次数、孕产史、本次妊娠合并症及并发症、新生儿信息等。单因素分析采用χ^(2)检验,多因素分析采用非条件多因素logistic回归分析。结果本次调查共有足月活产儿3553例,早产儿253例,早产率6.65%。经单因素分析显示,产妇的年龄、身体质量指数、孕期是否服用叶酸、产检次数、妊娠期高血压、早产史、双胎、辅助生殖是早产的高危因素(P<0.05)。多因素分析显示,产妇年龄≥40岁(OR=2.209,95%CI:1.199~4.070)、年龄<20岁(OR=2.496,95%CI:1.050~5.932)、早产史(OR=4.115,95%CI:1.226~13.809)、双胎(OR=6.676,95%CI:3.328~13.394)、妊娠期高血压(OR=2.413,95%CI:1.333~4.370)、未服用叶酸(OR=5.338,95%CI:3.984~7.151)均为早产的危险因素(均P<0.05)。结论2019年延庆区早产率与产妇年龄、早产史、双胎、妊娠期高血压、是否服用叶酸有关。多种因素均能导致早产,应继续加强本地区的孕产妇保健工作。

Objective To explore the risk factors of preterm birth and provide theoretical evidence for intervention and policy making.Methods Pregnant women who gave birth and established maternal-child health records in the community health service centers at Yanqing District,Beijing were recruited from January 1st,2019 to December 31th,2019.Research subjects included 3746 women and 3806 live newborn.The content of this study mainly included maternal age,education background,body mass index,folic acid intake,the number of prenatal examination,history of pregnancy and birth,pregnancy complications,neonatal information,etc.χ^(2) test was used for univariate analysis and non-conditional multivariate logistic regression was used for multivariate analysis.Results There were 3553 full-term live births and 253 preterm births,and the rate of preterm birth was 6.65%.Univariate analysis showed that the maternal age,body mass index,folic acid intake during pregnancy,the number of prenatal examinations,gestational hypertension,history of premature birth,twinbirth,and assisted reproduction were high risk factors related to preterm birth(P<0.05).Multivariate analysis revealed that,maternal age≥40 years old(OR=2.209,95%CI:1.199-4.070),maternal age<20 years old(OR=2.496,95%CI:1.050-5.932),history of preterm birth(OR=4.115,95%CI:1.226-13.809),twinbirths(OR=6.676,95%CI:3.328-13.394),gestational hypertension(OR=2.413,95%CI:1.333-4.370),no folic acid intake(OR=5.338,95%CI:3.984-7.151)were risk factors related to preterm birth(P<0.05).Conclusion Maternal age,history of premature birth,twinbirths,gestational hypertension and folic acid intake are related to preterm birth rate of Yanqing District in 2019.A variety of factors can lead to premature birth,and the maternal health care work in Yanqing District should be strengthened.