目的 探讨孕前产妇危险因素与早产的相关性。方法 数据来源于《国家免费孕前优生健康检查项目信息系统》和随访登记表。分别以早产、自然流产、低出生体重为应变量,拟合多因素Poisson回归模型。进一步采用样条函数与 Poisson回归相结合的限制性立方样条法(Restricted Cubic Spline,RCS)分析孕前体重、妇女年龄与早产的非线性剂量反应关系。结果 多因素Poisson回归模型结果显示,妇女年龄、孕前BMI、产次、孕前有乳腺增生、孕前白带清洁度是与早产的发生风险存在显著相关性。限制性立方样条模型显示,妇女年龄与早产之间呈“U”型剂量-反应关系,早产发生率最低的年龄在26岁左右。而孕前BMI与早产的发生风险存在“S” 型剂量-反应关系,当BMI>24时,随着BMI的增大,妇女早产的发生风险开始逐渐增大。结论 妇女年龄、孕前BMI对早产发生风险存在非线性剂量-反应关系,对孕前开展优生优育健康教育具有重大的指导意义。
Abstract
Objective To explore the correlation between risk factors of pregnant women and premature deliverybirth. Methods Data were collected from the National Free Prenatal Health Examination Project Information System and the follow-up registration form.Multivariate Poisson regression models wasere fitted with premature birth, spontaneous abortion and low birth weight as strain variables.Furthermore, Restricted Cubic Spline (RCS), which combines spline function with Poisson regression, was used to analyze the non-linear dose-response relationship between pre-pregnancy weight, women's age and preterm deliverybirth. Results The results of multivariate Poisson regression model showed that women's age, pre-pregnancy BMI before pregnancy, parity, number of births, pre-pregnancy mammary gland hyperplasia and pre-pregnancy leucorrhea cleanliness breast hyperplasia before pregnancy and cleanliness of leucorrhea before pregnancy were significantly correlated with the risk of premature deliverybirth.Restricted cubic spline model showed a U-shaped dose-response relationship between women's age and preterm deliverybirth, and the lowest incidence of preterm delivery birth was around 26 years old.There was a "S" dose-response relationship between pre-pregnancy BMI and the risk of premature bitthdelivery.When BMI was higher greater than 24, the risk of premature delivery birth began to increase gradually with the increase of BMI. Conclusion There is a non-linear dose-response relationship between women's age and , pre-pregnancy BMI and the risk of premature birth, which has important guiding significance for health education before pregnancy.and BMI before pregnancy is of great guiding significance for health education of eugenics and eugenics before pregnancy.
关键词
优生优育 /
危险因素 /
剂量反应关系 /
队列研究
Key words
Eugenics /
Risk factors /
Dose-response relationship /
Cohort study
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基金
中国疾病预防控制中心妇幼保健中心“2018年度合生元母婴营养与健康研究项目”(2018FYH016)
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