| 高翔宇,李姗姗,武文韬,杜姣洋,吴晨璐,蒋茜,张彬艳,米白冰,曾令霞,党少农,颜虹.陕西省育龄妇女围孕期钙补充与单胎小于胎龄儿的关联性探索分析[J].中华流行病学杂志,2021,42(4):651-655 |
| 陕西省育龄妇女围孕期钙补充与单胎小于胎龄儿的关联性探索分析 |
| The association between calcium supplementation in antenatal childbearing aged women and risk of small for gestational age among neonatal singleton in Shaanxi province |
| 收稿日期:2020-06-23 出版日期:2021-04-22 |
| DOI：10.3760/cma.j.cn112338-20200623-00877 |
| 中文关键词: 钙补充 小于胎龄儿 广义线性混合模型 |
| 英文关键词: Calcium supplement Small for gestational age infant Generalized linear mixed model |
| 基金项目:国家自然科学基金（81230016）；出生缺陷防治课题研究（Sxwsjswzfcght2016-013）；国家重点研发计划（2017YFC0907200，2017YFC0907201） |
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| 中文摘要: |
| 目的 探讨陕西省育龄妇女围孕期钙补充与单胎新生儿小于胎龄儿（SGA）发生风险之间的关联性。方法 采用多阶段随机整群抽样方法，以面对面问卷调查方式收集2010-2013年陕西省30个区（县）曾经怀孕且结局明确的育龄妇女及其生育子女信息。以单胎新生儿是否为SGA为因变量，分别以育龄妇女围孕期和不同孕期是否进行钙补充为自变量，调整协变量，采用广义线性混合模型进行建模分析。结果 最终纳入育龄妇女28 357名，年龄（28.08±4.74）岁；农村居民占79.28%；围孕期钙补充率达60.90%。单胎新生儿中，女婴12 810名（45.17%），体重为（3.27±0.16）kg，胎龄（277.44±8.80）d；SGA发生率为11.35%，其中母亲围孕期进行钙补充SGA发生率为10.48%，母亲围孕期未进行钙补充SGA发生率为12.70%。母亲是否为高龄产妇、母亲户籍、母亲职业、母亲产次、母亲文化程度、家庭经济状况对其围孕期是否进行钙补充的影响，差异均有统计学意义（P<0.05）。广义线性混合模型在调整上述协变量后，结果显示，育龄妇女围孕期进行钙补充，其单胎子女发生SGA风险减少16%（OR=0.84，95%CI：0.77~0.92）。进一步对围孕期的不同时期分析显示，孕中期和孕晚期进行钙补充对新生儿SGA发生风险的降低差异有统计学意义（P<0.05）。围孕期钙补充与SGA结局关联的亚组分析显示，非高龄产妇、母亲文化程度较低且家庭经济状况为中等，其围孕期进行钙补充与其单胎新生儿是否为SGA之间差异有统计学意义（P<0.05）。结论 育龄妇女围孕期进行钙补充与陕西省单胎新生SGA的发生风险降低有关。 |
| 英文摘要: |
| Objective This study explored the association between antenatal calcium supplementation in the childbearing aged women and risk of small for gestational age infant (SGA) among singleton in Shaanxi province,China. Methods Multi-stage random cluster sampling method was employed to collect information about pregnant women, who were pregnant and had definite outcomes, and their infants, from 30 districts (counties) in 2010 to 2013. Information was collected by face-to-face questionnaire survey. Generalized linear mixed models were employed after adjusting covariates. Dependent variable was whether single-birth neonate was SGA, and independent variable was calcium supplementation of childbearing aged women in different pregnant periods. Results A total of 28 357 childbearing aged women was recruited in this study. The age of these women was (28.08±4.74) years old, of which, 79.28% were rural residents and 60.90% had calcium supplementation intake. There was a number of 12 810 female in singleton neonates. The neonatal birth weight and gestational age were (3.27±0.16) kg and (277.44±8.80) day, respectively. The prevalence of SGA was 11.35% in total, and 10.48% in mothers with maternal calcium supplementation and 12.70% in mothers without maternal calcium supplementation in whole antenatal period. There were statistically significant differences seen in antenatal calcium supplementation within the subgroups of maternal age (whether the mother was an advanced maternal woman), residential area, maternal occupation, maternal parity, maternal education level, and household incomes (P<0.05). After adjusting these covariates, the risk of SGA among childbearing aged women with antenatal calcium supplementation showed 16% decreased risk (OR=0.84, 95%CI:0.77-0.92). Further analysis of the different antenatal periods showed that calcium supplementation during the second and third trimester had a statistically significant difference in reducing the risk of neonatal SGA (P<0.05). Besides, subgroup analysis showed that there was a statistically significant difference between the perinatal calcium supplementation and the single-born neonates with SGA Significance (P<0.05) in non-advanced women, those who had a low education level and moderate household economic status groups. Conclusion The risk reduction of SGA among singleton neonates is related to calcium supplementation during antenatal period in Shaanxi province. |
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