中国新生儿低出生体重危险因素的系统评价和Meta分析-东南大学学报医学版

中国新生儿低出生体重危险因素的系统评价和Meta分析

单位：江苏护理职业学院健康与康复学院, 江苏淮安 223300

分类号：R722

出版年·卷·期（页码）：2020·39·第六期（730-736）

摘要：

目的：探讨中国新生儿低出生体重的危险因素，为新生儿低出生体重的预防提供参考依据。方法：收集2008—2019年关于中国新生儿低出生体重危险因素的病例对照研究文献进行Meta分析，由两名研究人员独立提取数据，按照纽卡斯尔渥太华（NOS）量表对纳入文献进行质量评价，异质性检验采用Q检验和I²统计量，敏感性分析采用不同模型分析同一资料，发表偏倚采用Egger's检验和剪补法评估。结果：共纳入22篇病例对照研究文献，其中病例组样本9 396例，对照组样本14 357例。Meta分析结果显示，中国新生儿低出生体重的危险因素是孕周不满37周（OR=17.165，95%CI为7.516~39.203）、孕母高龄（OR=1.392，95%CI为1.078~1.797）、妊娠期高血压（OR=3.591，95%CI为2.613~4.963）、母亲从事体力劳动职业（OR=1.402，95%CI为1.075~1.829）、孕期紧张焦虑（OR=1.609，95%CI为1.237~2.092）、孕期营养不良（OR=3.703，95%CI为2.099~6.531）、孕早期阴道出血（OR=1.842，95%CI为1.110~3.056）、不良孕产史（OR=1.329，95%CI为1.064~1.660）。效能检验结果显示除孕母高龄外，其余因素的效能均大于80%。结论：孕周不满37周、孕母高龄、妊娠期高血压、母亲从事体力劳动职业、孕期紧张焦虑、孕期营养不良、孕早期阴道出血、不良孕产史可能增加新生儿低出生体重的发生风险。

Objective: To investigate the risk factors for low birth weight in Chinese neonates,and to provide reference for prevention of low birth weight. Methods: Systematic review of case-control studies published between 2008 and 2019 regarding risk factors for low birth weight in Chinese neonates was performed by Meta-analysis. Data were extracted independently by two researchers. The quality of selected studies was evaluated according to the NOS scale. Chi-square tests of homogeneity and the I² statistic were used to evaluate the heterogeneity of the included studies. Sensitivity analysis was conducted by using different models to analyze the same data. Publication bias was assessed by Egger's tests and the trim and filling method. Results: A total of 22 case-control studies were selected,including 9 396 cases and 14 357 controls. Results of the Meta-analysis show that the risk factors of low birth weight in Chinese neonates were as follows:gestation <37 weeks(OR=17.165,95%CI 7.516-39.203),mother with advanced age(OR=1.392,95%CI 1.078-1.797),gestational hypertension(OR=3.591,95%CI 2.613-4.963),occupation of the mother as labor-insensive workers(OR=1.402,95%CI 1.075-1.829),stress and anxiety during pregnancy(OR=1.609,95%CI 1.237-2.092),malnutrition during pregnancy(OR=3.703,95%CI 2.099-6.531),vaginal bleeding during early pregnancy(OR=1.842,95%CI 1.110-3.056),and abnormal pregnancy history(OR=1.329,95%CI 1.064-1.660). The power analysis revealed that the power of all risk factors was greater than 80% except for the age factor. Conclusion: Gestation <37 weeks,mother with advanced age,gestational hypertension,occupation of mother as labor-intensive workers,stress and anxiety during pregnancy,malnutrition during pregnancy,vaginal bleeding in early pregnancy,and abnormal pregnancy history may increase the risk of low birth weight in Chinese neonates.

参考文献：

[1] 李玫,王颖,解冰洁,等.母亲出生体重与新生儿出生体重的关系研究[J].中华疾病控制杂志,2017,21(3):295-298,307.
[2] 刘爱萍,张若,李照青,等.陕西省活产单胎新生儿低出生体重现况及其影响因素分析[J].中华流行病学杂志,2015,36(11):1244-1248.
[3] LAMICHHANE D K,LEEM J H,LEE J Y,et al. A meta-analysis of exposure to particulate matter and adverse birth outcomes[J].Environ Health Toxicol,2014,30(2):1-19.
[4] 詹思延. 流行病学[M]. 北京:人民卫生出版社,2014:86.
[5] LICHTENSTEIN M J,MULROW C D,ELWOOD P C. Guidelines for reading case-control studies[J].J Chronic Dis,1987,40(9):893-903.
[6] MIZUGUCHI T,KAWAMOTO M,MEGURO M,et al. Laparoscopic hepatectomy:a systematic review,meta-analysis,and power analysis[J].Surg Today,2011,41(1):39-47.
[7] 张玉臻,齐骥,李慧,等.低出生体重儿影响因素及并发症分析[J].泰山医学院学报,2019,40(9):659-662.
[8] YANG S,YANG R,LIANG S,et al. Symptoms of anxiety and depression during pregnancy and their association with low birth weight in Chinese women:a nested case control study[J].Arch Womens Ment Health,2017,20(2):1-8.
[9] JING W,YUN Z,NI Z M,et al. Risk factors for low birth weight and preterm birth:a population-based case-control study in Wuhan,China[J].J Huazhong Univ Sci Technolog,2017,37(2):286-292.
[10] 张巧玲,黄惠梅,苏红梅. 广州市萝岗区2011至2015年低出生体重儿危险因素分析[J].中国妇幼健康研究,2016,27(7):801-804.
[11] 李雪梅,何丹,蒋秋静,等.重庆市低出生体重儿影响因素的病例对照研究[J].中国儿童保健杂志,2016,24(8):863-866.
[12] 姜蕾,陈斌,赵光临,等.深圳市低出生体重影响因素的配对病例对照研究[J].中华疾病控制杂志,2015,19(11):1131-1134,1157.
[13] 刘颖,耿晓丽,何金荣,等.低出生体重儿发生因素的研究[J].延安大学学报(医学科学版),2014,12(4):62-64.
[14] 林琴君,王晓红. 影响低出生体重儿发生率的相关危险因素分析[J].解放军护理杂志,2013,30(23):51-53.
[15] 周敏,张小松,郝波,等.西部388例足月低出生体重儿危险因素的病例对照研究[J].中国儿童保健杂志,2013,21(11):1136-1138.
[16] 陈铮铮,刘江海. 低出生体重儿发生的相关危险因素分析[J].中国医师进修杂志,2013,36(4):51-52.
[17] 朱娟,赵庆国,尹爱华,等.低出生体重儿危险因素的病例对照研究[J].国际医药卫生导报,2013,19(22):3432-3435.
[18] 应圣洁,宫志敏,王健,等.上海市闵行区低出生体重儿危险因素研究[J].健康教育与健康促进,2012,7(2):90-92,131.
[19] 应项吉,王丽萍,吴志平,等.兰州市低出生体重儿妊娠期危险因素的病例对照研究[J].中国妇幼保健,2011,26(36):5735-5736.
[20] 牛志民,李艳红,李玉洁. 低出生体重儿发生率及相关因素的病例对照[J].青岛医药卫生,2011,43(2):111-113.
[21] 刘银梅,沈月平,罗小明,等.低出生体重儿危险因素病例对照研究[J].实用妇产科杂志,2011,27(1):39-42.
[22] 吴涤,杨艳芳,关明杰,等.新生儿出生体重影响因素的研究[J].中国妇幼保健,2011,26(10):1505-1507.
[23] 郑敏,李燕,钱存芬,等.贫困农村地区低出生体重影响因素病例对照研究[J].中国妇幼保健,2010,25(27):3898-3900.
[24] 黄梅,王小燕,岳高峰,等.低出生体重儿相关因素的1:1病例对照研究[J].中国医疗前沿(上半月),2009,4(15):73-74.
[25] 黄渊清. 低出生体重儿发生的危险因素及干预研究[D]. 福建:福建医科大学,2008.
[26] 季静敏,徐飚,陈梦如,等.649例低出生体重儿危险因素分析[J]. 中国妇幼保健,2008,23(32):4581-4583.
[27] 周炜茹,杨起鹏,杨晓慧,等.江门市新会区低出生体重儿影响因素调查与干预对策研究[J].中国初级卫生保健,2008,22(5):43-45.
[28] 林玲,顾曰萍,阚海东,等.上海市长宁区足月低出生体重儿危险因素的病例对照研究[J].环境与职业医学,2008,25(2):163-166,170.
[29] WACHAMO T M,BILILIGN Y N,BIZUNEHI A D. Risk factors for low birth weight in hospitals of North Wello zone,Ethiopia:a case-control study[J].PLoS One,2019,14(3):1-15
[30] 余峰,黄晓霞,尉敏琦,等.上海某区足月新生儿低出生体重的影响因素分析[J].环境与职业医学,2015,32(4):289-295.
[31] 柴鸣荣,邸晓华,陈健萍,等.超低出生体重儿30例并发症及高危因素分析[J].广东医学,2015,36(22):3519-3520.
[32] 张雪,刘凯波,刘凤洁,等.妊娠期高血压综合征对围产儿不良妊娠结局的影响[J].中国妇幼保健,2018,33(22):5132-5134.
[33] 岳月,李玉萍,王松柏,等.妊娠期高血压及孕期健康教育对低出生体重影响[J].中国公共卫生,2016,32(12):1708-1711.
[34] DI M D,MAGROMALOSSI E R,SACCONE G,et al. Exercise during pregnancy in normal-weight women and risk of preterm birth:a systematic review and meta-analysis of randomized controlled trials[J].Am J Obstet Gynecol,2016,215(5):561-571.
[35] 刘毅,卓琳,朱蓓,等.妊娠期抑郁症与新生儿低出生体重关系的Meta分析[J].中国当代儿科杂志,2017,19(9):994-998.
[36] DOWNES K L,GRANTZ K L,SHENASSA E D. Maternal,labor,delivery,and perinatal outcomes associated with placental abruption:a systematic review[J].Am J Perinatol,2017,34(10):935-957.
[37] 陈奕,李光辉,邹丽颖,等.我国低出生体重儿的影响因素[J].中华围产医学杂志,2015,18(10):755-760
[38] 田旭,曾子,毛智,等.应用SAS软件宏命令实现Meta分析统计效能计算[J].中国循证医学杂志,2015,15(1):110-115.

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