2014—2019年西安地区新生儿极低及低出生体重率变化趋势及影响因素分析

Change trend and influencing factors of the incidence of very low and low birth weight infants in Xi’an,2014-2019

目的分析西安地区新生儿极低及低出生体重率变化趋势及影响因素,为极低及低出生体重新生儿的防治提供理论依据。方法2014—2019年户籍为西安且在西北妇女儿童医院出生的婴儿及其产妇资料来自本地区母婴管理系统,采用回顾性分析方法分析极低及低出生体重新生儿发生情况,并进行极低及低出生体重新生儿影响因素分析。结果纳入2014—2019年西安地区活产新生儿41683名,其中极低出生体重儿共387例,占0.93%,平均出生体重(1190.8±232.1)g;低出生体重儿共1182例,占2.84%;平均出生体重(2195.4±240.1)g。极低及低出生体重发生率从2014年至2019年随年份呈显著下降趋势(P<0.01)。多因素Logistic回归分析结果显示,孕前BMI≤18.5 kg/m^(2)(OR=4.104)、发生胎盘早剥(OR=2.732)、发生前置胎盘(OR=3.093)、发生胎膜早破(OR=3.557)、合并妊娠期高血压(OR=2.519)、经产妇(OR=4.586)、多胎(OR=3.056)、早产(OR=3.823)是极低及低出生体重儿的危险因素。结论西安地区新生儿极低及低出生体重发生率虽然呈逐年下降趋势,但因受多种因素的影响,现状并不乐观,应对具有危险因素的孕妇采取综合预防措施,进而降低极低及低出生体重儿的发生率。

Objective To analyze the change trend and influencing factors of the incidence of very low and low birth weight infants in Xi'an,and to provide theoretical basis for the prevention and treatment of very low and low birth weight infants.Methods Data of infants registered in Xi'an and born in Northwest Women's and Children's Hospital and their mothers from 2014 to 2019 were collected from the maternal and infant management system in the region.The inci⁃dence of very low and low birth weight infants was retrospectively analyzed,and the influencing factors of very low and low birth weight infants were analyzed.Results From 2014 to 2019,41683 newborns were born live in Xi'an,of which 387 were born with very low birth weight,accounting for 0.93%,with an average birth weight of(1190.8±232.1)g.There were 1182 low birth weight infants,accounting for 2.84%,with an average birth weight of(2195.4±240.1)g.The inci⁃dence of very low birth weight and low birth weight was significantly decreased from 2014 to 2019(P<0.01).Multivariate Logistic regression analysis showed that pre⁃pregnancy body mass index≤18.5 kg/m^(2)(OR=4.104),placenta abruption(OR=2.732),placenta previa(OR=3.093),premature rupture of membranes(OR=3.557),complicated with gesta⁃tional hypertension(OR=2.519),multiparous(OR=4.586),multiple births(OR=3.056),and premature delivery(OR=3.823)were the risk factors for very low and low birth weight infants.Conclusions The incidence of very low and low birth weight infants in Xi'an is decreasing year by year,but the current situation is not optimistic due to the influence of many factors.Comprehensive preventive measures should be taken for pregnant women with risk factors to reduce the inci⁃dence of very low and low birth weight infants.