分娩年龄与不良妊娠结局的关联强度剂量反应关系

Dose-response relationship between maternal age and adverse pregnancy outcomes

目的探讨女性分娩年龄与早产、足月低出生体质量儿(LBW)、巨大儿关联强度的剂量反应关系。方法选取2020年1月1日至2023年12月31日广西壮族自治区柳州地区助产机构出生的新生儿为研究对象。使用Logistic回归及限制性立方样条法分析分娩年龄与早产、LBW、巨大儿关联强度及其剂量反应关系。结果Logistic回归模型显示,调整因素产妇常住地、有无妊娠期并发症、孕期贫血、受孕方式、是否多胎妊娠、胎儿性别后,与分娩年龄25~29岁相比,<20岁组、30~34岁组、≥35岁组子代早产发生风险明显增加;<20岁组、20~24岁组子代足月LBW发生风险明显增加;≥35岁组的子代巨大儿发生风险明显增加。限制性立方样条模型显示,调整因素产妇常住地、有无妊娠期并发症、孕期贫血、受孕方式、是否多胎妊娠、胎儿性别后,分娩年龄与分娩早产儿及足月LBW风险的关联强度呈非线性“U”形剂量-反应关系曲线;与分娩巨大儿风险的关联强度呈正向线性剂量-反应关系。结论女性分娩年龄与子代早产和足月LBW的发生呈“U”形关系,高龄妊娠和低龄妊娠子代早产及足月LBW风险均增加;另外,高龄妊娠子代巨大儿风险增加。

Objective To explore the dose-response relationship between maternal age and the strength of association with preterm birth,term low birth weight(LBW),and macrosomia.Methods Newborns born in obstetric institutions in Liuzhou,Guangxi from January 1,2020,to December 31,2023,were selected as the study subjects.Logistic regression and restricted cubic spline analysis were used to analyze the association strength and dose-response relationship between maternal age and premature,LBW,and macrosomia.Results The Logistic regression model showed that after adjusting for factors such as maternal residence,pregnancy complications,anemia during pregnancy,conception method,multiple pregnancies,and fetal gender,compared to the 25-29 age group,the<20 age group,30-34 age group,and≥35 age group had significantly increased of preterm birth.The<20 age group,20-24 age group had significantly increased of term LBW.The≥35 age group had an increased of macrosomia.The restricted cubic spline model showed that after adjusting for factors such as maternal residence,pregnancy complications,anemia during pregnancy,conception method,multiple pregnancies,and fetal gender,the association strength between maternal age and preterm birth and term LBW exhibited a non-linear“U”shaped dose-response relationship,while the association strength with macrosomia exhibited a positive linear dose-response relationship.Conclusion The occurrence of preterm birth and term LBW in offspring is a“U”shaped relationship with maternal age,with an increased risk for both advanced maternal age and young maternal age.Additionally,there is an increased risk of macrosomia in offspring of advanced maternal age.