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【目的】调查广东巨大儿发生率及探讨其高危因素。【方法】收集中山大学附属第一医院等广东13所大型医院产科2010年10月至2010年11月住院分娩的巨大儿(≥4000 g)共222例作为研究组,随机抽取同期正常体质量(2 500～3 999 g)的新生儿414例作为对照组。计算巨大儿发生率,比较两组间孕妇年龄、孕次、产次、身高、孕前体质量、产前体质量、孕期增重、孕周、分娩方式、新生儿体质指标、孕妇及新生儿并发症等情况,统计分析巨大儿的相关因素及高危因素。【结果】巨大儿共222例,总发生率为2.78%;两组间孕妇孕期增重有统计学差异[对照组(15±5)kg vs巨大儿组(18±5)kg,P<0.05];巨大儿组中妊娠期糖尿病(16.9%vs 5.6%,P<0.01)、羊水过多(7.8%vs 1.2%,P<0.01)的发生率更高;巨大儿组顺产率更低(20.1%vs 47.5%,P<0.05),手术产率更多(78.5%vs 51.0%,P<0.01);巨大组和对照组的男女婴比例有显著差异(146/76 vs 229/185,P<0.01);头围也有统计学差异[(35.75±1.07)cm vs(33.70±1.53)cm,P<0.01]。分娩巨大儿的相关因素为孕周、孕次、身高、孕前体质量、孕前BMI、产前体质量、产前BMI、孕期增重等;分娩巨大儿的高危因素为年龄、孕周、产前体质量、妊娠期糖尿病等。【结论】广东巨大儿发生率约为2.78%,高危因素为年龄、孕周、产前体质量、妊娠期糖尿病等;在具有分娩巨大儿高危因素的孕妇当中,要注意筛查巨大儿,特别是在四步触诊临床估计胎重及超声测量中。
【Objective】 To investigate the incidence of macrosomia in Guangdong and its risk factors. 【Methods】 A total of 222 giant children (≥4000 g) admitted to the First Affiliated Hospital of Sun Yat-sen University from 13 obstetrics and gynecology clinics in Guangdong from October 2010 to November 2010 were selected as the research group and randomly selected normal body mass 2 500 ~ 3 999 g) of 414 newborns as a control group. The incidence of macrosomia was calculated and the pregnant women’s age, pregnancy time, delivery time, height, pre-pregnancy weight, prenatal body weight, weight gain during pregnancy, gestational age, mode of delivery, physical indicators of newborn, pregnant women and neonates were compared Symptoms and other conditions, statistical analysis of the macrosomia related factors and risk factors. 【Results】 The results showed that there were 222 cases of macrosomia with a total incidence of 2.78%. The weight gain of pregnant women during pregnancy was significantly different between the two groups [15 ± 5 kg vs 18 ± 5 kg, P <0.05 (16.9% vs 5.6%, P <0.01), polyhydramnios (7.8% vs 1.2%, P <0.01) in the Giant group, and lower birth rate in Giant children (20.1 % vs 47.5%, P <0.05). The rate of operation was more (78.5% vs 51.0%, P <0.01). There were significant differences in the male and female infants in the huge and control groups (146/76 vs 229/185, P < 0.01). There was also a significant difference in head circumference [(35.75 ± 1.07) cm vs (33.70 ± 1.53) cm, P <0.01]. Pregnancy, gestational age, height, pre-pregnant body weight, pre-pregnancy BMI, prenatal body weight, prenatal BMI, weight gain during pregnancy, etc. The risk factors of childbirth for macrosomia were age, gestational age, prenatal Body mass, gestational diabetes and so on. 【Conclusion】 The incidence of giant macrosomia in Guangdong is about 2.78%. The high risk factors are age, gestational age, prenatal body mass, gestational diabetes mellitus. Among the pregnant women who have the risk of giving birth to giant macrosomia, Is a four-step palpation clinically estimated fetal weight and ultrasound measurements.