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高海拔地区低体重儿发生状况及影响因素分析
吴曼,殷晓颖,贲馨馨,胡玉利,肖梅,章琼*
0
(中国人民解放军东部战区总医院妇产科, 南京 210002
*通信作者)
摘要:
目的 探讨高海拔地区低体重儿的发生情况及影响因素。方法 选取我院帮带西藏自治区安多县人民医院(当地平均海拔5 200 m)在2022年4月至2023年4月分娩的活产儿340例,统计低体重儿发生情况,并分析母亲一般资料、妊娠期及围生期合并症、妊娠晚期血清5种金属元素(Ca、Fe、Mg、Zn、Cu)水平对低体重儿发生的影响。结果 本次调查发现低体重儿发生率为18.24%(62/340)。母亲年龄、孕次、产次、妊娠初期BMI、不良孕产史、妊娠期糖尿病及新生儿性别与低体重儿发生情况无明显关系。妊娠期高血压、妊娠期肝内胆汁淤积症、妊娠期贫血、胎膜早破、羊水过少、早产组低体重儿发生率分别高于无妊娠期高血压、无妊娠期肝内胆汁淤积症、无妊娠期贫血、无胎膜早破、无羊水过少、足月产组,差异有统计学意义(均P<0.001);低体重儿组母亲妊娠晚期血清Ca、Fe、Mg、Zn和Cu水平低于非低体重儿组,差异有统计学意义(均P<0.001)。多因素logistic回归分析结果显示,妊娠期高血压、妊娠期肝内胆汁淤积症、胎膜早破、早产及母亲妊娠晚期血清Ca、Zn和Cu水平是引起低体重儿的影响因素(均P<0.001)。结论 高海拔地区低体重儿的发生受妊娠期高血压、妊娠期肝内胆汁淤积症、胎膜早破、早产等多种因素的影响,同时与母亲妊娠晚期血清Ca、Zn和Cu水平有关。
关键词:  高海拔地区  低体重儿  影响因素  妊娠期并发症    微量元素
DOI:10.16781/j.CN31-2187/R.20230575
投稿时间:2023-11-30修订日期:2024-02-20
基金项目:
Incidence and influencing factors of low birth weight at high altitude
WU Man,YIN Xiaoying,BEN Xinxin,HU Yuli,XIAO Mei,ZHANG Qiong*
(Department of Obstetrics and Gynecology, General Hospital of Eastern Theater Command of PLA, Nanjing 210002, Jiangsu, China
* Corresponding author)
Abstract:
Objective To explore the incidence and influencing factors of low birth weight in infants in high altitude areas. Methods A total of 340 live births delivered in the People’s Hospital of Anduo County, Xizang (with an average local altitude of 5 200 m) from Apr. 2022 to Apr. 2023 were enrolled, and the incidence of low birth weight was recorded. The effects of maternal general information, pregnancy and perinatal complications, and serum levels of 5 metal elements (calcium [Ca], iron [Fe], magnesium [Mg], zinc [Zn], and copper [Cu]) in the third trimester of pregnancy on the incidence of low birth weight were analyzed. Results The incidence of low birth weight was 18.24% (62/340). The incidence of low birth weight in infants had no relation with maternal age, pregnancy times, parity, body mass index at the beginning of pregnancy, adverse pregnancy history, gestational diabetes mellitus or neonatal gender. The incidences of low birth weight in mathers with gestational hypertension, gestational intrahepatic cholestasis, gestational anemia, premature rupture of membranes, oligohydramnios, and preterm birth were significantly higher than that in mothers without the above symptoms (all P<0.001). The maternal serum levels of Ca, Fe, Mg, Zn, and Cu in the third trimester of pregnancy of the low birth weight group were significantly lower than those in the non-low birth weight group (all P<0.001). Multivariate logistic regression analysis showed that gestational hypertension, gestational intrahepatic cholestasis, premature rupture of membranes, premature birth, maternal serum Ca, Zn, and Cu levels were the influencing factors of the low birth weight (all P<0.001). Conclusion The incidence of low birth weight in infants in high altitude areas is affected by gestational hypertension, gestational intrahepatic cholestasis, premature rupture of membranes, and premature delivery, and it is also related to the maternal serum levels of Ca, Zn and Cu in the third trimester of pregnancy.
Key words:  high altitude areas  low birth weight infants  influencing factors  pregnancy complications  calcium  trace element