Abstract: Objective To understand the change trends and its influencing factors of Zhang-Lu index (ZLI) among urban term newborns in China. Methods This study adopted a random cluster sampling strategy.Subjects were term singleton live newborns.Data were collected in four cities:Beijing,Harbin,Changsha and Guangzhou.Data were including all subjects' neonatal physical development conditions.Data analysis included comparison analysis and regression analysis.Comparison analysis was used to compare the study data with the national reference ZLI value.Regression analysis was used to identify ZLI influencing factors. Results A total of 5 140 subjects were included in this study (Beijing:n=1 207,Harbin:n=1 271,Changsha:n=1 250,and Guangzhou:n=1 412).In 2012,the value of term newborns (ranging 37 to 41 weeks' gestational age) of this study was higher than the national reference ZLI value collected between the years of 1989-1990.The ZLI values had statistically significant difference (P<0.01),and the average increasing mean value was 0.07.By multiple linear regression analysis,it indicated that main factors influencing the ZLI value were gestational age,maternal pre-pregnancy body mass index,gestational weight gain,maternal parity,age,education level,occupation,and neonatal gender. Conclusion The ZLI values of term newborns displays increasing trends among these studied four cities.In order to improve the quality of births,it should reduce the incidence of premature delivery,adjust pre-pregnancy body mass index in a appropriate level,appropriately regulate weight gain during pregnancy,and conduct pre-pregnancy and prenatal health education.

Key words: newborn, Zhang-Lu index, change trends, influencing factors

摘要： 目的 了解我国城市足月新生儿张路指数(Zhang-Lu index,ZLI)的变化及其影响因素。方法 采取随机整群抽样的方法收集了北京、哈尔滨、长沙及广州4个城市足月单胎活产新生儿体格发育数据,并与全国ZLI参考值进行对比分析,运用多元线性回归模型筛选ZLI影响因素。本次共调查足月新生儿5 140例,其中北京1 207例,哈尔滨1 271例,长沙1 250例,广州1 412例。结果 1)2012年37~41周不同胎龄新生儿ZLI均大于利用1989-1990年收集的数据建立的全国ZLI参考值,差异有统计学意义(P＜0.01),ZLI平均增长值为0.07。2)多元线性回归分析显示,影响ZLI主要因素为胎龄、母亲妊娠前体质指数及妊娠期增加体重,母亲产次、年龄、文化程度、职业及新生儿性别等对ZLI影响不大。结论 我国四城市足月新生儿张路指数的变化呈现增加趋势。为提高出生人口质量,应从降低导致早产的原发性疾病的发生、做好孕前体质指数调控及科学制定孕期适宜增重标准等可控因素进行孕前及孕期健康指导。

关键词: 新生儿, 张路指数, 变化趋势, 影响因素