2016—2020年云南省低出生体质量发生现状及影响因素分析

Current status and influencing factors of low body weight at birth in Yunnan Province from 2016 to 2020

目的探讨2016—2020年云南省低出生体质量发生率变化趋势及相关影响因素。方法收集2016—2020年云南省助产机构分娩产妇和活产儿的资料,排除非云南省户籍、数据不全、异常个案的资料。对产妇年龄、民族、现住址、孕产次、分娩孕周、胎儿数量及新生儿性别进行统计分析,采用多因素Logistic回归分析活产儿低出生体质量发生的危险因素。结果2016—2020年云南省低出生体质量发生率为5.17%。低出生体质量发生率从2016年的4.93%上升至2020年的5.48%,整体呈上升趋势,年度变化百分比(APC)为2.74%(t=4.67,P=0.018)。以低出生体质量发生与否为因变量,将单因素分析中有统计学意义的变量作为自变量,采用进入法进入多因素Logistic回归模型。分析结果显示:产妇年龄<20岁或≥35岁、少数民族(彝族、苗族、傣族、壮族、其他民族)、居住地类别为Ⅱ、Ⅲ类、孕次=1次或≥3次、产次=1次或≥3次、早产、多胎和女婴是低出生体质量发生的影响因素(P<0.05)。足月儿组中,产妇年龄<20岁或≥35岁、少数民族、居住地类别为Ⅱ、Ⅲ类、孕产次=1次或≥3次、多胎和女婴为低出生体质量发生的影响因素(P<0.05);早产儿组,产妇年龄<20岁、少数民族、居住地类别为Ⅱ类、产次=1次、多胎和女婴为低出生体质量发生的影响因素(P<0.05)。结论2016—2020年云南省低出生体质量发生率逐年上升,早产是造成低出生体质量发生率居高不下的重要因素。相关部门应加强对早产结局的预防,以及对低龄产妇、多胎妊娠的干预。

Objective This paper aims to investigate the incidence of low body weight at birth and related factors in Yunnan Province from 2016 to 2020.Methods The data of parturients and live births delivered in midwifery institutions in Yunnan Province from 2016 to 2020 were collected.We excluded data that were from non-Yunnan province household registration,or incomplete and missing,as well as abnormal cases.Maternal age,ethnicity,current address,number of pregnancies,gestational age at delivery,number of fetuses,and neonatal sex underwent statistical analyses.Multivariate logistic regression was used to analyze the risk factors for the presence of low body weight at birth.Results The incidence of low body weight at birth in Yunnan Province from 2016 to 2020 was 5.17%.The incidence of low body weight at birth increased overall from 4.93%in 2016 to 5.48%in 2020,with an annual percentage change(APC)of 2.74%(t=4.67,P=0.018).The multivariate logistic regression model was entered using the entry method with the presence or absence of low body weight at birth as the dependent variable and the variables that were statistically significant in the univariate analysis as independent variables.The results showed that maternal age under 20 years or at 35 years or above,ethnic minorities(Yi,Miao,Dai,Zhuang,and other ethnic minority groups),residence categoryⅡandⅢ,1 or no less than 3 times of pregnancy,1 or no less than 3 parity,premature delivery,multiple births,and female infants were the influencing factors for the presence of low body weight at birth(P<0.05).In the term group,maternal age under 20 years or at 35 years or above,ethnic minorities,residence categoryⅡandⅢ,1 or no less than 3 times of pregnancy and parity,multiple births,and female infants were the influencing factors for the presence of low body weight at birth(P<0.05).In the preterm group,maternal age under 20 years,ethnic minorities,residence categoryⅡ,single parity,multiple births,and female infants were the influencing factors for the occurrence of low body weight at birth(P<0.05).Conclusion The incidence of low body weight at birth in Yunnan Province increased year by year from 2016 to 2020,and premature delivery is an important factor causing the high incidence.Relevant departments should strengthen the prevention of preterm birth outcomes,as well as intervention for younger parturients and parturients with multiple pregnancies.