2020-2024年安徽省黄山市新生儿出生体重变化趋势及相关因素OA
Trends in birth weight and associated factors among newborns in Huangshan,Anhui Province from 2020 to 2024
[目的]分析安徽省黄山市新生儿出生体重分布特征、时间变化趋势及相关因素,为制定区域性围产保健策略提供依据.[方法]数据来自黄山市妇幼保健信息平台,收集2020年1月—2024年12月黄山市所有助产机构分娩的37 757例活产儿的临床资料,分析新生儿出生体重分布情况,通过Cochran-Armitage趋势检验分析低出生体重(LBW)、巨大儿发生率的时间变化趋势,并探讨影响新生儿出生体重的相关因素.[结果]新生儿平均出生体重为(3 258.27±449.34)g,男婴平均出生体重高于女婴(P<0.001)[(3 306.86±455.12)g;(3 206.00±437.05)g].LBW总体发生率为4.13%,从2020年的3.73%上升到2024年的4.66%,呈逐年上升趋势(χ²趋势=12.75,P趋势<0.001),巨大儿总体发生率为5.10%,从2020年的5.79%下降至2024年的4.25%,呈逐年下降趋势(χ²趋势=17.37,P趋势<0.001).将单因素分析中有统计意义的性别、分娩季节、出生孕周、胎数、产妇户籍、产妇年龄、产次及分娩方式等因素作为自变量纳入logistic回归分析,结果显示早产(OR=33.13,95%CI:29.22~37.57)、双胎(OR=10.16,95%CI:8.27~12.49)、女婴(OR=1.45,95%CI:1.28~1.64)及剖宫产(OR=1.22,95%CI:1.07~1.38)与LBW发生正相关(均P<0.05),产妇城市户籍(OR=0.77,95%CI:0.66~0.90)与LBW负相关.足月(OR=14.29,95%CI:7.12~28.67)、经产(OR=1.34,95%CI:1.10~1.641)、剖宫产(OR=1.93,95%CI:1.76~2.12)及夏秋冬季分娩(OR=1.15~1.32)与巨大儿发生正相关(均P<0.05).双胎(OR=0.03,95%CI:0.01~0.20)、女婴(OR=0.58,95%CI:0.52~0.64)与巨大儿负相关.产妇年龄≥35岁的LBW和巨大儿发生在两模型中均未见统计学关联.[结论]黄山市新生儿出生体重存在性别差异,LBW发生率上升与巨大儿发生率下降趋势应引起重视,建议该地区围产保健重点加强对早产高危人群、乡村户籍产妇及双胎妊娠的早期干预,同时合理把控剖宫产指征,优化母婴结局.
[Objective]To analyze the distribution characteristics,temporal trends,and related factors of neonatal birth weight in Huangshan,Anhui Province,and to provide evidence for the formulation of regional perinatal health care strategies.[Methods]Data were obtained from the Huangshan City Maternal and Child Health Information Platform.Clinical records of 37 757 live births delivered at all midwifery institutions in Huangshan City from January 2020 to December 2024 were collected to analyze the distribution of birth weight.The Cochran-Armitage trend tests were applied to examine the temporal trends in the incidence of low birth weight(LBW)and macrosomia,and associated factors influencing neonatal birth weight.[Results]The mean neonatal birth weight was(3 258.27±449.34)g,with male infants having a significantly higher mean birth weight than female infants(P<0.001)[(3 306.86±455.12)g;(3 206.00±437.05)g].The overall incidence of LBW was 4.13%,increasing from 3.73%in 2020 to 4.66%in 2024,showing a significant upward trend over years(χ²trend=12.75,Ptrend<0.001).The overall incidence of macrosomia was 5.10%,decreasing from 5.79%in 2020 to 4.25%in 2024,showing a significant downward trend over years(χ²trend=17.37,Ptrend<0.001).Multivariate logistic regression analyses were performed on the statistically significant factors identified in univariate analyses(gender,season of delivery,gestational age at birth,number of fetuses,maternal household registration,maternal age,parity,and mode of delivery).The results showed that preterm birth(OR=33.13,95%CI:29.22-37.57),twin pregnancy(OR=10.16,95%CI:8.27-12.49),female sex(OR=1.45,95%CI:1.28-1.64),and cesarean delivery(OR=1.22,95%CI:1.07-1.38)were positively correlated with LBW(all P<0.05),while maternal urban household registration(OR=0.77,95%CI:0.66-0.90)was negatively correlated with LBW.Term birth(OR=14.29,95%CI:7.12-28.67),multiparity(OR=1.34,95%CI:1.10-1.641),cesarean delivery(OR=1.93,95%CI:1.76-2.12),and delivery in summer,autumn and winter(OR=1.15-1.32)were positively associated with macrosomia(all P<0.05).Twin pregnancy(OR=0.03,95%CI:0.01-0.20)and female sex(OR=0.58,95%CI:0.52-0.64)were negatively associated with macrosomia.Maternal age 35 years old and above showed no statistically significant association with LBW or macrosomia in either models.[Conclusion]Significant gender differences in neonatal birth weight were observed in Huangshan City.The rising trend in LBW incidence and the declining trend in macrosomia incidence warrant attention.It is recommended that perinatal care in this region should prioritize early intervention for populations at high risk of preterm birth,mothers with rural household registration mothers,and twin pregnancies,while rationally controlling indications for cesarean delivery to optimize maternal and neonatal outcomes.
刘阁玉
黄山市妇幼保健计划生育服务中心,安徽 黄山 245000
医药卫生
新生儿低出生体重巨大儿发生率变化趋势
neonatelow birth weightmacrosomiaincidencetrend
《上海预防医学》 2026 (4)
311-314,321,5
评论