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目的探讨环境相关危险因素与小于胎龄儿(简称SGA)之间的关系。方法采用公认的SGA的判别标准和太原市不同胎龄新生儿的出生体重分布,利用新生儿出生医学记录,确定太原市2005年11月—2012年期间出生的SGA,并对母亲发生SGA的相关影响因素进行分析。结果研究期间太原市SGA的发生率为7.91%(22 047/278 710),且呈现明显的下降趋势,男婴的SGA发生率高于女婴。单因素logistic回归分析显示,母亲孕期主、被动吸烟[RR=1.29(95%CI:1.08~1.56),RR=1.10(95%CI:1.01~1.20)]、饮酒[RR=1.22(95%CI:1.01~1.46)]以及其他不良因素暴露[RR=1.25(95%CI:1.00~1.56)]是SGA的危险因素。煤炉取暖、电取暖和做饭也是SGA发生的危险因素,用煤炉和电取暖的RR值分别为1.71(95%CI:1.65~1.78)和1.53(95%CI:1.35~1.73),用其做饭的RR值分别为1.32(95%CI:1.27~1.37)和1.33(95%CI:1.26~1.39)。厨房安装使用油烟机可以明显降低SGA的发生率(安装:6.53%;未安装:9.10%),RR值为0.70(95%CI:0.67~0.72)。控制了混杂因素以后,与城市集中供暖、用气体燃料做饭比较,家庭用电取暖[RR=1.18(95%CI:1.10~1.26)]或做饭[RR=1.08(95%CI:1.03~1.15)的母亲SGA发生率较高,具有统计学意义(P<0.05),厨房安装并使用抽油烟机的母亲SGA发生率较低[RR=0.91(95%CI:0.87~0.95)]。结论母亲孕期饮酒、主被动吸烟、其他有害因素暴露以及用煤和电作为取暖做饭能源是SGA的危险因素,改善家庭居住生活条件,建立良好的生活习惯可有效降低SGA的发生。
Objective To explore the relationship between environmental risk factors and small gestational age (SGA). Methods The accepted criteria of SGA and the birth weight distribution of neonates of different gestational ages in Taiyuan were used to determine the SGA born in Taiyuan from November 2005 to 2012 and the correlation of SGA with their mothers Influencing factors were analyzed. Results The incidence of SGA in Taiyuan was 7.91% (22 047/278 710) during the study period, showing a significant downward trend. The incidence of SGA in male infants was higher than that of female infants. Univariate logistic regression analysis showed that the main and passive mothers during pregnancy were RR = 1.29 (95% CI: 1.08-1.56), RR = 1.10 (95% CI: 1.01-1.20) : 1.01 ~ 1.46)] and other adverse factors [RR = 1.25 (95% CI: 1.00-1.56)] are risk factors for SGA. Coal furnace heating, electric heating and cooking are also risk factors for SGA. The RRs for coal-fired and electric heating were 1.71 (95% CI: 1.65-1.78) and 1.53 (95% CI: 1.35-1.73) The RR of cooking was 1.32 (95% CI: 1.27-1.37) and 1.33 (95% CI: 1.26-1.39, respectively). The installation of the hood in the kitchen significantly reduced the incidence of SGA (6.53% for installation: 9.10% for no installation), with an RR of 0.70 (95% CI: 0.67-0.72). After controlling the confounding factors, household electricity heating [RR = 1.18 (95% CI: 1.10-1.26)] or cooking [RR = 1.08 (95% CI: 1.03 ~ 1.15) had a higher incidence of SGA among mothers (P <0.05). The incidence of SGA was lower in mothers with kitchen hoods and using range hoods (RR = 0.91 (95% CI: 0.87-0.95)]. Conclusion It is a risk factor of SGA that mothers drink during pregnancy, active and passive smoking, exposure of other harmful factors, and use of coal and electricity as heating energy to improve their living conditions and establish good habits can effectively reduce the occurrence of SGA.