产次对中国育龄女性营养与健康状况的影响

Effects of parity on nutrition and health status of Chinese women of childbearing age

目的产次对中国育龄女性营养与健康状况的影响。方法数据来源于2016—2017年中国0~17岁儿童青少年与乳母营养健康监测。采用多阶段分层随机抽样方法,纳入中国31个省份17 771名产后0~24个月的女性为研究对象。通过问卷调查收集一般人口学特征、产次、分娩方式、怀孕前体重、分娩前体重、孕前和孕期疾病、有无产后大出血,测量当前身高、体重、腰围、血压,检测血红蛋白、血糖、血脂,计算孕前体重指数(BMI)、孕期增重、产后体重滞留、产后BMI、贫血率、高血压率、糖尿病率、血脂异常率。根据抽样设计和全国第六次人口普查数据中2岁以下儿童数据,进行复杂抽样加权处理后,采用多因素线性回归和多因素logistic回归模型分析产次对营养和健康指标的影响。结果 17 771名产妇的年龄为(29.5±5.0)岁,超过35岁不满40岁的产妇占12.2%(2 172名),超过40岁的产妇占3.2%(563名);一、二、三胎产妇分别占47.3%(8 413名)、48.5%(8 620名)、4.2%(738名);城市产妇占49.9%(8 875名),农村产妇占50.1%(8 896名)。多因素线性回归结果显示,与一胎产妇相比,二胎和三胎产妇的孕前BMI分别高0.55 kg/m2和0.76 kg/m2;多因素logistic回归模型分析结果显示,与一胎产妇相比,三胎产妇的孕前贫血风险OR(95%CI)为1.45(1.04~2.02),二胎产妇的孕期贫血风险OR(95%CI)为1.20(1.06~1.35)。结论产次与育龄女性的孕前BMI和孕前及孕期贫血患病风险有关联。

Objective To analyze effects of parity on women′s nutrition and health status.Methods This study was based on the data bank of"Chinese Nutrition and Health Surveillance of Children and Adolescents Aged 0-17 years old and Lactating Mothers from 2016 to 2017".Using a multi-stage stratified random sampling method,17771 women at 0 to 24 months postpartum from 31 provinces in China's Mainland were included in this study.Questionnaires were used to collect data on women′s general demographic characteristics,parity,mode of delivery,pre-pregnancy weight,pre-delivery weight,diseases before and during pregnancy,postpartum hemorrhage.Current body height,body weight,waist circumference,and blood pressure were measured.Blood hemoglobin,blood glucose and blood lipids were detected.Pre-pregnancy BMI,gestational weight gain,postpartum weight retention,postpartum BMI,the rates of anemia,hypertension,diabetes,and dyslipidemia were calculated.Survey sample weights were calculated according to the sampling design and number of children under 2 years old from the sixth population census data of China.Effects of parity on the observational indicators after adjusting for confounding factors were analyzed by multivariate linear regression and multivariate logistic regression.Results The age of 17771 women was(29.5±5.0)years old,12.2%(2172)were over 35 but less than 40 years old,and 3.2%(563)were over 40 years old;the women with one parity,two parities,and three parities accounted for 47.3%(8413),48.5%(8620)and 4.2%(738),respectively;urban women accounted for 49.9%(8875),and rural women accounted for 50.1%(8896).The results from multivariate linear regression showed that the pre-pregnancy BMI of women with two and three parities was 0.55 kg/m2 and 0.76 kg/m2 higher than women with one parity,respectively;the results of multivariate logistic regression showed that the OR(95%CI)of pre-pregnancy anemia was 1.45(1.04-2.02)for women with three parities compared with women with one parity,and the OR(95%CI)of anemia during pregnancy for women with two parities was 1.20(1.06-1.35)compared with women with one parity.Conclusion Parity is associated with pre-pregnancy BMI and risk of anemia before and during pregnancy in women of reproductive age.