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Title

重慶市2005-2009低出生體重嬰兒及其影響因素分析

English Abstract

Low Birth Weight (LBW) is defined as the weight less than 2500g in one hour after birth, among which, the birth weight less than 1500g is called Very Low Birth Weight (VLBW). The Low Birth Weight Infants (LBWI) include preterm infants (gestational age less than 37 weeks), full term infants and post-term but small for gestational age infants. More than 20 million infants worldwide are born with low birth weight every year, with 19 million in developing countries. In China, the incidence of LBW has kept on the rise these years, and the situation seems even worse for the poor areas in interior cities. The causes of LBW haven't been fully clarified so far. However, it is thought to closely linked to preterm birth and restricted foetal (intrauterine) growth, along with complex and multiple risk factors, such as the fetal factors either physiological or pathological, the mother's diseases, nutritional status, maternal age, socio-economic conditions and so on. With regards to this, the paper has given a thorough review here on the study of risk factors of LBW at home and abroad. LBW is associated with perinatal mortality, neonatal mortality, infant mortality and mortality of children under five years, and meanwhile is related to post-infant disability, bringing terrible consequences to the individual throughout life and constituting heavy burden of diseases to the society. The incidence of LBW has been seen as an important indicator reflecting the socio-economic status of a country or a region and for monitoring progress towards internationally agreed-upon goals, and has been accorded great importance to along with the risk factors these decades. Many counties have kept searching for effective interventions to reduce LBW. As there is a significant variation in LBW incidence along with the risk factors across areas, it is necessary to conduct more empirical researches which are region representative and then to explore cause-specific interventions.This research located in Chongqing, the interior hyper-megalopolis, and cooperated with The Children's Hospital of Chongqing University of Medical Sciences for purpose of data source and professional supports. A retrospective study through file revision was conducted on 2709 Low Birth Weight Hospitalized Infants in The Children's Hospital of Chongqing from 2005 to 2009, which leading the results: LBWI have kept an important proportion in the hospitalized newborns in Chongqing, with the mean of 13.47%; the mortality of VLBWI was 8.79 times than that of all the other hospitalized Infants with normal birth weight; The majority of LBWI were preterm birth ones, which took up the percentage of 87.4%; infectious diseases and the complication of pregnancy all seemed as serious problems to the LBWI's mothers; the maternal age of the mothers converged on the group between 20 and 40 yeas old; mothers who were out of work formed an arresting component. Besides, according to multiple linear regression, gestational age, hypertensive disorder complicating pregnancy, multiple fetus, sex of the infant, rural-urban location, intrahepatic cholestasis of pregnancy, maternal age and multiple parturition all contributed to the incidence of LBW in Chongqing. Therefor, the key intervention strategy suitable for Chongqing is to attach great importance to pregnancy health care, preventing preterm birth, and to make full use of neonatal intensive care unit along with the strength of obstetrics for the purpose of reduce the mortality of LBWI. Key words: Low Birth Weight Infants, risk factors, intervention

Chinese Abstract

低出生体重指出生 1 小时内体重低于 2500g,其中,出生体重小于 1500g 的 称极低出生体重。低出生体重儿包括早产儿(指胎龄小于 37 周的新生儿)、足月 儿及过期小于胎龄儿。 全球每年新增的低出生体重儿超过2000万,其中有1900多万来自发展中国家。 近年来,我国低出生体重发病率似有上升趋势,内陆贫困地区情势尤显严峻。 低出生体重的病因目前尚未完全阐明,主要与早产及胎儿宫内发育阻滞有 关,受胎儿自身生理、病理情况,母亲疾病、营养状态,母亲年龄及社会经济地 位等多因素影响。本文对低出生体重发病影响因素的国内外研究及其结果进行了 全面细致的阐述。 低出生体重与围产期死亡率、新生儿死亡率、婴儿死亡率及 5 岁以下儿童死 亡率密切相关,并有较高致病致残率,对患婴带来可能贯整个生命周期的一系列 不良预后,对社会则造成沉重的经济负担。 近二十多年来,国际社会对低出生体重的发生及影响因素予以越来越高的重 视程度。低出生体重发生率已被视作一个国家或地区社会经济状态的反映,同时 也是衡量进步水平的全球性指标。各国政府为寻求有效的疾病干预措施进行了一 系列的尝试。鉴于低出生体重的发生及各类影响因素的作用程度因地域的不同而 存在差异,具有区域代表性的实证研究及以此为依据所制定的具有区域代表性的 疾病干预策略则显得尤为重要。 本研究立足于我国西部大型内陆直辖市重庆,联合西南地区儿科权威机构以 获取数据保障及专业支持,同时承载儿科医学及公共卫生管理作为学科背景。研 究选取重庆儿童医院新生儿诊疗中心从 2005 年 1 月至 2009 年 9 月收治的 2709 例低出生体重儿作为研究样本,以病史查阅的方式回顾性分析患儿一般情况及进 行五年的动态比较,并通过多元线性回归分析对重庆市低出生体重发病主要影响 因素进行分析探索。研究结果显示:重庆低出生体重儿在新生儿住院病患中占有 较大比例,平均占 13.47%;在住院新生儿中,极低出生体重儿的死亡率明显高 于正常出生体重的其他病患,其死亡率平均为正常的 8.79 倍;重庆低出生体重 儿以早产儿居多,占 87.4%;低出生体重儿母亲中,孕期感染性疾病,胎儿宫内窘迫、胎膜早破、羊水异常及高血压等妊娠合并症患病情况突出;孕母年龄集中 分布在 20~40 岁组段,职业构成上以无业者居多。另外,多元线性回归分析结果 显示,患儿胎龄,母亲妊娠高血压综合症,胎数,患儿性别,城乡分布、母亲妊 娠胆淤、母亲生育年龄及产次为重庆市低出生体重发病的重要影响因素。 为此,重庆市政府、各级医疗机构应对低出生体重的防治工作予以高度重视, 作好孕产妇卫生保健工作,密切监护高危妊娠妇女,防止早产发生,以降低低出 生体重发病率,并建立起有效的产科儿科联合救治机制,竭力降低低出生体重儿 死亡率。 关键词:低出生体重婴儿;影响因素;干预

Issue date

2010

Author

晏青

Faculty

Institute of Chinese Medical Sciences

Degree

M.Sc.

Subject

Medicinal Administration -- Institute of Chinese Medical Sciences

Premature infants -- China -- Chung Ching

早產嬰兒 -- 中國 -- 重慶

Birth weight, Low -- China -- Chung Ching

低出生體重嬰兒 -- 中國 -- 重慶

Child Development

Supervisor

卞鷹

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Location
1/F Zone C
Library URL
991006584319706306