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目的:探讨足月小于胎龄儿的围产结局及其危险因素。方法:随机选择1 200例足月分娩的单胎产妇,比较足月小于胎龄儿与适于胎龄儿的围产结局;应用多因素Logistic回归逐步法分析孕妇年龄、文化程度、孕次、产次、孕周、身高、孕前体重指数、孕期增重、胎儿性别、妊娠期糖尿病、妊娠期高血压疾病、脐血脂联素浓度与小于胎龄儿之间的关系。结果:(1)小于胎龄儿胎儿窘迫、新生儿窒息及进入NICU治疗的发生率高于适于胎龄儿(P<0.05)。(2)Logistic回归分析后按照校正OR值从大到小排序,小于胎龄儿的发生危险因素依次为为孕妇孕前体重指数<18.5 kg·m-2、孕期体重增加<11.5 kg、妊娠期高血压疾病、妊娠期糖尿病、孕妇身高<160 cm、孕次>1次、女婴、脐血脂联素浓度低于中位数水平、分娩孕周≥40周、产次>1、孕妇年龄、大学及大学以上文化程度。结论:小于胎龄儿的围产结局较差;其重要的发病危险因素中孕妇孕前体重指数和孕期增重是可调控因素,应及时予以干预;而及时发现和治疗妊娠期高血压疾病对于减少小于胎龄儿的发生也有重要意义。
Objective: To investigate the perinatal outcome and its risk factors in term children younger than gestational age. Methods: One hundred and twenty-one single-term pregnant women of full-term delivery were randomly selected to compare the perinatal outcomes of full-term children less than gestational age and suitable for gestational age. Multivariate logistic regression was used to analyze the age, education level, Birth weight, gestational age, height, body mass index before pregnancy, weight gain during pregnancy, fetal gender, gestational diabetes mellitus, gestational hypertension, uridine-natriuretic peptide concentration and the number of small gestational age children. Results: (1) The incidence of fetal distress, neonatal asphyxia and NICU treatment were higher than those of gestational age (P <0.05). (2) According to the logistic regression analysis, the OR of the correction was ranked in descending order. The risk factors of less than gestational age were as follows: the pre-pregnancy body mass index <18.5 kg · m-2, weight gain during pregnancy <11.5 kg, Blood pressure disease, gestational diabetes, pregnant women, height <160 cm, gestational age> 1, infant, umbilical blood adiponectin concentration lower than the median level, gestational age ≥ 40 weeks, delivery time> 1, pregnant women age, university And college education. Conclusions: The perinatal outcome of infants younger than gestational age is poor. The body mass index of pregnant women before pregnancy and the weight gain during pregnancy are the most important risk factors to be adjusted. Intervention should be timely; however, the timely detection and treatment of hypertensive disorder complicating pregnancy should be reduced The occurrence of children younger than gestational age is also of great significance.