【目的】 描述中国三省六县农村地区巨大儿发生率及三间分布特征。 【方法】 采用分层整群随机抽样相结合的方法抽取三省六县25个医疗机构2008年入院分娩的活产儿病案进行问卷摘录。 【结果】 共收录合格问卷17 805份,巨大儿发生率为9.91%(95%CI:9.47,10.35),男婴12.01%,女婴7.54%。蒙城和泌阳巨大儿率均达15%以上,其中男婴达18%以上,高出当地女婴近6个百分点。春季娩出的巨大儿率高于其他三个季节,差异有统计学意义。随着分娩年龄的升高,巨大儿发生率有升高趋势;农民、孕产次数多、超重、过期妊娠的妇女巨大儿率较高;妇女产检次数和首次产检孕周均与巨大儿率呈U形曲线关系,差异有统计学意义。 【结论】 安徽河南农村地区巨大儿发生率已达较高水平。农村地区巨大儿发生率男婴高于女婴,春季高发,不同特征人群的妇女巨大儿发生率也显箸不同。
Abstract
【Objective】 To describe the epidemiological distribution of fetal macrosomia in six counties (2 counties×3 provinces) of rural China. 【Method】 Stratified random cluster sampling was used to sample medical records of all live births in 2008 in 25 research medical institution. 【Results】 17 805 live births were investigated. The macrosomia incidence in rural China was 9.91%(95%CI:9.47,10.35), male for 12.01% and female for 7.54%. The macrosomia incidence in Mengcheng and Biyang County both reached to 15%. Male macrosomia reached to 18%, which was higher six percents than female infants. The incidence of macrosomia born in spring was higher than that of other seasons. Macrosomia incidence trended to rise with the increase of delivery age. Increased macrosomia incidence was observed in women with peasants, more parities, overweight and prolonged pregnancy. Relations between birth check frequency, first birth check week and macrosomia incidence appeared to be U-shaped, all the differences had statistical significance(P<0.05). 【Conclusions】 The 2008 macrosomia incidence in Anhui and Henan have reached to a high level. The male macrosomia incidence is higher than female in rural China. The incidence of macrosomia born in spring is higher and it show significant difference between characteristic maternal population.
关键词
巨大儿 /
农村地区 /
流行病学
Key words
fetal macrosomia /
rural areas /
epidemiological distribution
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参考文献
[1] 乐杰.妇产科学[M].6版.北京:人民卫生出版社,2003:130-131.
[2] Barker DJP. The developmental origins of adult disease[J]. Eur J Epidemiol,2003,18:733-736.
[3] Vatten L. Can prenatal factors influence future breast cancer risk? [J]. Lancet,2004,348:1531-1533.
[4] 于冬梅,翟凤英,赵丽云,等.中国 2006 年巨大儿发生率及其影响因素[J].中国儿童保健杂志,2008,16(1):11-13.
[5] 林良明,刘玉琳,张新利,等.1998 年中国低出生体重发生率的分布特点及影响因素[J].中国儿童保健杂志,2001,9(4):217-220.
[6] 中国肥胖工作指南问题工作组.中国成人体质指数分类的推荐意见[J].中华预防医学杂志,2001,35(5):349-350.
[7] 刘兰,刘建蒙,刘英惠,等.中国10县(市)1993~2005年单胎儿早产流行状况研究[J].中华流行病学杂志,2007,28(11):1051-1054.
[8] Langer O. Fetal macrosomia: etiologic factor[J]. Clin Obstet Gynecol,2000,43(2):283-286.
[9] Sheree L, Greg R, Hamisu M. Secular trends in cesarean delivery rates among macrosomic deliveries in the United States, 1989 to 2002[J]. Journal of Perinatology,2005,25:569-576.
[10] 高竟,葛峰,乐杰.巨大儿的分娩管理与肩难产的处理[J].国外医学·妇产科学分册,2001,28(3):245-246.
[11] 许厚琴,杜莉,秦敏,等.上海市巨大儿影响因素及妊娠结局的调查[J].中国妇幼保健,2010,25(9):1184-1188.
[12] Berle P. The macrosomia neonate: lncidence, early morbidity and leal aspects: an analysis of the Hessian perinatal study[J]. Z Geburt Shilfe Neonatol,1997,201(2):55-57.
[13] Abram BF, Laros RK. Pre-pregnancy weight, weight gain, and birth weight[J]. Am J Obstet Gynecol,1986,154:503-509.
[14] 郑九生,黄维新.巨大胎儿的病因及流行病学调查[J].中国实用妇科与产科杂志,2002,18(10):577-578.
[15] 卞晓云,吴红荷,陈坚,等.659例巨大儿危险因素1∶1配比病例对照研究[J].中国妇幼保健,2006,21(22):3091-3094.
[16] 刘军.贫困山区巨大儿发生状况分析[J].中国妇幼保健,2010,25(14):1939-1940.
[17] 沈艳辉,李竹,季成叶,等.孕前体重孕期增重与新生儿出生体重的关系[J].中华围产医学杂志,2000,3(2):77-79.
基金
国家人口与计划生育委员会十二五规划项目(20090728)