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目的探讨环境、生物-心理、保健因素对减少低出生体重儿发生的作用。方法采用回顾性病例-对照研究方法,选择2004年11月至2005年9月在福建省妇幼保健院出生的婴儿及产妇,对在该院分娩的179例产妇于产后24 h进行问卷调查和摘取病历。结果变量为新生儿出生体重,采用双侧t检验、卡方检验或确切概率法进行单因素分析,再将有意义的变量进一步入选Logistic回归分析。结果丈夫吸烟与饮酒、丈夫情绪、胎儿性别喜好与居住面积5个环境因素,产妇年龄与身高、产妇孕期情绪等7个生物-心理因素,孕期接受群组健康教育、初检孕周、产前检查次数、胎儿脐血流监测、衣原体检测、支原体检测6个保健因素在病例-对照组中差异均有统计学意义。病例组丈夫吸烟每日半包以上达35.2%,是对照组的2.2倍,病例组丈夫经常饮酒达20.3%,是对照组的2.7倍;病例组19~22岁的产妇占16.2%,是对照组的3.4倍,病例组35岁以上的产妇占9.5%,是对照组的2.5倍(P<0.01);病例组孕期处于紧张或抑郁情绪占16.2%,是对照组的2.1倍(P<0.05)。多元Logistic回归分析结果为丈夫吸烟、丈夫情绪、胎儿性别喜好、群组健康教育、胎儿脐血流监测和衣原体检测等6个因素与低出生体重有关。结论环境、生物-心理因素与低出生体重间存在密切相关性;适宜的孕期保健,即早孕检查、适宜的保健次数和参加了群组孕期健康教育及孕期异常情况监测是干预早产低出生体重发生的重要手段。
Objective To investigate the effects of environment, biopsychosocial and health factors on reducing the incidence of low birth weight infants. Methods A retrospective case-control study was conducted to select infants and mothers born in MCH in Fujian Province from November 2004 to September 2005. A total of 179 mothers in this hospital were surveyed and picked up at 24 h postpartum Take medical records. Results The variables were newborns’ birth weights. Univariate analysis was performed by two-tailed t-test, chi-square test or exact probabilistic method. Logistic regression analysis was further used to make meaningful variables. Results Husband smoking and drinking, husband emotion, fetal sex preferences and living area of five environmental factors, maternal age and height, maternal mood and other seven bio-psychological factors during pregnancy group health education, initial pregnancy test, prenatal Check the number of fetal cord blood flow monitoring, detection of chlamydia, mycoplasma detection of six health factors in the case-control group differences were statistically significant. Case group husband smoked half a day more than 35.2%, 2.2 times the control group, the husband of the case group often 20.3% of alcohol consumption, 2.7 times that of the control group; case group 19 to 22 years of maternal accounted for 16.2% of the control (P <0.01). The incidence of stress or depression in case group was 16.2%, which was 2.1 times that of the control group (P <0.05) ). Multivariate logistic regression analysis showed that 6 factors related to low birth weight were related to husband smoking, husband emotion, fetal sex preferences, group health education, fetal umbilical blood flow monitoring and detection of chlamydia. Conclusions There is a close correlation between environment, bio-psychology and low birth weight. The appropriate prenatal care, that is, the inspection of early pregnancy, the appropriate number of times of health care and participation in the group health education during pregnancy and the monitoring of abnormal pregnancy during pregnancy are interventions for low birth weight premature birth The important means.