不同程度小于胎龄儿发生的影响因素分析

doi:10.7499/j.issn.1008-8830.2308057

Abstract
Figure/Table
References(27)
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (576 KB) HTML
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective To investigate the factors influencing the occurrence of small for gestational age (SGA) at different degrees and provide a basis for early identification of severe SGA cases. Methods Neonatal and maternal prenatal information were retrospectively collected from January 2018 to December 2022 at Peking University People's Hospital. The neonates were divided into three groups: severe SGA group (birth weight below the 3rd percentile for gestational age and sex), mild SGA group (birth weight ≥3rd percentile and <10th percentile), and non-SGA group (birth weight ≥10th percentile). An ordered multinomial logistic regression model was used to analyze the factors influencing the occurrence of SGA at different degrees. Results A total of 14 821 neonates were included, including 258 cases (1.74%) in the severe SGA group, 902 cases (6.09%) in the mild SGA group, and 13 661 cases (92.17%) in the non-SGA group. The proportions of preterm births and stillbirths were higher in the severe SGA group compared to the mild SGA and non-SGA groups (P<0.0125). The proportion of neonatal asphyxia was higher in both the severe SGA and mild SGA groups compared to the non-SGA group (P<0.0125). Ordered multinomial logistic regression analysis showed that maternal pre-pregnancy underweight (OR=1.838), maternal pre-pregnancy obesity (OR=3.024), in vitro fertilization-embryo transfer (OR=2.649), preeclampsia (OR=1.743), connective tissue disease during pregnancy (OR=1.795), nuchal cord (OR=1.213), oligohydramnios (OR=1.848), and intrauterine growth restriction (OR=27.691) were all associated with a higher risk of severe SGA (P<0.05). Maternal parity as a multipara (OR=0.457) was associated with a lower likelihood of severe SGA (P<0.05). Conclusions Maternal pre-pregnancy underweight, maternal pre-pregnancy obesity, in vitro fertilization-embryo transfer, preeclampsia, connective tissue disease during pregnancy, oligohydramnios, nuchal cord, and intrauterine growth restriction are closely related to the occurrence of more severe SGA. Maternal parity as a multipara acts as a protective factor against the occurrence of severe SGA.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	ZHANG Yi-Min
	SHAO Shu-Ming
	YU Chen
	ZHANG Xiao-Rui
	LIU Zheng
	LI Yang-Yang
	QIN Jiong

Key words： Small for gestational age Risk factor Body mass index Multipara Neonate

Received: 14 August 2023

Cite this article:

ZHANG Yi-Min,SHAO Shu-Ming,YU Chen et al. Factors influencing the occurrence of small for gestational age at different degrees[J]. CJCP, 2024, 26(3): 262-268.

URL:

http://www.zgddek.com/EN/10.7499/j.issn.1008-8830.2308057 OR http://www.zgddek.com/EN/Y2024/V26/I3/262

	Wilcox AJ, Cortese M, McConnaughey DR, et al. The limits of small-for-gestational-age as a high-risk category[J]. Eur J Epidemiol, 2021, 36(10): 985-991. PMID: 34661814. DOI: 10.1007/s10654-021-00810-z.
	Castagno M, Menegon V, Monzani A, et al. Small-for-gestational-age birth is linked to cardiovascular dysfunction in early childhood[J]. Am Heart J, 2019, 217: 84-93. PMID: 31520898. DOI: 10.1016/j.ahj.2019.08.004.
	Sacchi C, Marino C, Nosarti C, et al. Association of intrauterine growth restriction and small for gestational age status with childhood cognitive outcomes: a systematic review and meta-analysis[J]. JAMA Pediatr, 2020, 174(8): 772-781. PMID: 32453414. PMCID: PMC7251506. DOI: 10.1001/jamapediatrics.2020.1097.
	Ludvigsson JF, Lu DH, Hammarstr?m L, et al. Small for gestational age and risk of childhood mortality: a Swedish population study[J]. PLoS Med, 2018, 15(12): e1002717. PMID: 30562348. PMCID: PMC6298647. DOI: 10.1371/journal.pmed.1002717.
	Tamai K, Yorifuji T, Takeuchi A, et al. Associations of birth weight for gestational age with child health and neurodevelopment among term infants: a nationwide Japanese population-based study[J]. J Pediatr, 2020, 226: 135-141.e4. PMID: 32640270. DOI: 10.1016/j.jpeds.2020.06.075.
	6 胡绪林, 陈妍, 夏红萍, 等. 不同程度小于胎龄儿的母体临床危险因素分析[J]. 上海交通大学学报（医学版）, 2020, 40(4): 489-493. DOI: 10.3969/j.issn.1674-8115.2020.04.012.
	7 首都儿科研究所, 九市儿童体格发育调查协作组. 中国不同出生胎龄新生儿出生体重、身长和头围的生长参照标准及曲线[J]. 中华儿科杂志, 2020, 58(9): 738-746. DOI:10.3760/cma.j.cn112140-20200316-00242.
	8 中华医学会健康管理学分会, 中国营养学会临床营养分会, 全国卫生产业企业管理协会医学营养产业分会, 等. 超重或肥胖人群体重管理流程的专家共识（2021年)）[J]. 中华健康管理学杂志, 2021, 15(4): 317-322. DOI: 10.3760/cma.j.cn115624-20210630-00368.
	9 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 4版. 北京: 人民卫生出版社, 2011.
	10 周美婷, 李培, 李蕾, 等. 孕期亲密伴侣暴力和孕晚期就寝-晨起规律与小于胎龄儿的关系[J]. 中国心理卫生杂志, 2021, 35(2): 133-139. DOI: 10.3969/j.issn.1000-6729.2021.02.008.
	11 陈甘讷, 吴泳, 黄伟雯, 等. 单胎活产儿小于胎龄儿发生率及影响因素分析[J]. 中国儿童保健杂志, 2019, 27(10): 1105-1108. DOI: 10.11852/zgetbjzz2019-0431.
	Lindstr?m L, Wikstr?m AK, Bergman E, et al. Born small for gestational age and poor school performance: how small is too small?[J]. Horm Res Paediatr, 2017, 88(3-4): 215-223. PMID: 28697501. DOI: 10.1159/000477905.
	Anon. Management of stillbirth: obstetric care consensus No, 10[J]. Obstet Gynecol, 2020, 135(3): e110-e132. PMID: 32080052. DOI: 10.1097/AOG.0000000000003719.
	Meler E, Martinez-Portilla RJ, Caradeux J, et al. Severe smallness as predictor of adverse perinatal outcome in suspected late small-for-gestational-age fetuses: systematic review and meta-analysis[J]. Ultrasound Obstet Gynecol, 2022, 60(3): 328-337. PMID: 35748873. DOI: 10.1002/uog.24977.
	刘艳, 王圆媛, 程雁, 等. 江苏省儿童生长发育状况及其影响因素: 基于0~6岁儿童家庭的横断面研究[J]. 中国当代儿科杂志, 2022, 24(6): 693-698. PMID: 35652424. PMCID: PMC9250398. DOI: 10.7499/j.issn.1008-8830.2202072.
	Wei J, Wang T, Shu J, et al. Parental pre-pregnancy body mass index and risk of low birth weight in offspring: a prospective cohort study in central China[J]. Front Public Health, 2022, 10: 1036689. PMID: 36530688. PMCID: PMC9748483. DOI: 10.3389/fpubh.2022.1036689.
	Santos S, Voerman E, Amiano P, et al. Impact of maternal body mass index and gestational weight gain on pregnancy complications: an individual participant data meta-analysis of European, North American and Australian cohorts[J]. BJOG, 2019, 126(8): 984-995. PMID: 30786138. PMCID: PMC6554069. DOI: 10.1111/1471-0528.15661.
	Luke B, Gopal D, Cabral H, et al. Pregnancy, birth, and infant outcomes by maternal fertility status: the Massachusetts outcomes study of assisted reproductive technology[J]. Am J Obstet Gynecol, 2017, 217(3): 327.e1-327.e14. PMID: 28400311. PMCID: PMC5581226. DOI: 10.1016/j.ajog.2017.04.006.
	Maheshwari A, Pandey S, Shetty A, et al. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryos generated through in vitro fertilization treatment: a systematic review and meta-analysis[J]. Fertil Steril, 2012, 98(2): 368-377.e9. PMID: 22698643. DOI: 10.1016/j.fertnstert.2012.05.019.
	Weinerman R, Ord T, Bartolomei MS, et al. The superovulated environment, independent of embryo vitrification, results in low birthweight in a mouse model[J]. Biol Reprod, 2017, 97(1): 133-142. PMID: 28859279. PMCID: PMC6248797. DOI: 10.1093/biolre/iox067.
	李婷, 朱丽敏, 张艳平, 等. 重度子痫前期极早产小于胎龄儿临床特点分析[J]. 中国当代儿科杂志, 2021, 23(3): 254-258. PMID: 33691918. PMCID: PMC7969190. DOI: 10.7499/j.issn.1008-8830.2011006.
	Ismail KI, Hannigan A, Kelehan P, et al. Small for gestational age infants and the association with placental and umbilical cord morphometry: a digital imaging study[J]. J Matern Fetal Neonatal Med, 2020, 33(21): 3632-3639. PMID: 30760075. DOI: 10.1080/14767058.2019.1582628.
	吴琳琳, 林新祝, 郑直, 等. 绒毛膜血管病对新生儿的影响: 450例临床分析[J]. 中国当代儿科杂志, 2021, 23(5): 494-498. PMID: 34020740. PMCID: PMC8140339. DOI: 10.7499/j.issn.1008-8830.2102055.
	Duley L, Meher S, Hunter KE, et al. Antiplatelet agents for preventing pre-eclampsia and its complications[J]. Cochrane Database Syst Rev, 2019, 2019(10): CD004659. PMID: 31684684. PMCID: PMC6820858. DOI: 10.1002/14651858.CD004659.pub3.
	Haase I, Fischer-Betz R. State of the art: fertility and pregnancy in rheumatic diseases[J]. Z Rheumatol, 2021, 80(8): 699-706. PMID: 34535818. DOI: 10.1007/s00393-021-01073-5.
	Lin L, Lu C, Chen W, et al. Parity and the risks of adverse birth outcomes: a retrospective study among Chinese[J]. BMC Pregnancy Childbirth, 2021, 21(1): 257. PMID: 33771125. PMCID: PMC8004392. DOI: 10.1186/s12884-021-03718-4.
	Prefumo F, Bhide A, Sairam S, et al. Effect of parity on second-trimester uterine artery Doppler flow velocity and waveforms[J]. Ultrasound Obstet Gynecol, 2004, 23(1): 46-49. PMID: 14970999. DOI: 10.1002/uog.908.