Abstract
黄晓春,仇小强,曾小云,刘顺,韦芳练,黎燕宁,刘韬,武亚楠,冯宝莹,蒋群姣,黄东萍.父母地中海贫血与早产及低出生体重的关系研究[J].Chinese journal of Epidemiology,2019,40(5):596-600
父母地中海贫血与早产及低出生体重的关系研究
Associations of parental thalassemia with preterm birth and low birth weight
Received:October 27, 2018  
DOI:10.3760/cma.j.issn.0254-6450.2019.05.020
KeyWord: 地中海贫血  早产  低出生体重
English Key Word: Thalassemia  Preterm birth  Low birth weigh
FundProject:国家自然科学基金(81360440,81460517);广西科技计划(桂科AB17195012)
Author NameAffiliationE-mail
Huang Xiaochun Department of Health Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Qiu Xiaoqiang Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Zeng Xiaoyun Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Liu Shun Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Wei Fanglian Dpartment of Obstetrics, Guangxi Debao County of Maternal and Child Health Hospital, Debao 531400, China  
Li Yanning Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Liu Tao Department of Health Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Wu Yanan Department of Health Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Feng Baoying Department of Health Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Jiang Qunjiao Department of Health Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China  
Huang Dongping Department of Health Chemistry, School of Public Health, Guangxi Medical University, Nanning 530021, China dongpinghuang@gxmu.edu.cn 
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Abstract:
      目的 探讨父母妊娠合并地中海贫血(地贫)对新生儿早产和低出生体重的影响。方法 选择2017年1-12月在广西壮族自治区靖西市、德保县人民医院或妇幼保健院进行产前检查的孕妇及其丈夫作为研究对象,从中选取经过地贫基因诊断确诊一方或双方均为地贫且有妊娠结局的父母共758对作为地贫组,选择地贫基因诊断为正常或者地贫筛查、血红蛋白电泳检测均为阴性且有妊娠结局的父母共758对作为非地贫组,并将地贫组按是否罹患地贫分为母亲地贫组、父亲地贫组以及父母双方地贫组,收集研究对象的临床、妊娠结局资料,采用独立样本t检验、χ2检验以及Cox回归分析等统计学方法对父母罹患地贫与新生儿早产和低出生体重的关系进行分析。结果 新生儿早产发生率在地贫组和非地贫组中分别约为6.5%、1.6%,低出生体重发生率分别约为7.3%、0.8%。校正可能存在的混杂因素后,Cox回归分析结果显示,母亲地贫组(aRR=3.45,95% CI:1.35~8.81,P=0.010)、父亲地贫组(aRR=4.93,95% CI:2.16~11.21,P<0.001)及父母双方地贫组(aRR=5.13,95% CI:2.62~10.04,P<0.001)均与新生儿早产风险增加相关;母亲地贫组(aRR=12.98,95% CI:4.91~34.30,P<0.001)、父亲地贫组(aRR=9.40,95% CI:3.40~25.95,P<0.001)及父母双方地贫组(aRR=10.74,95% CI:4.44~26.00,P<0.001)均与新生儿低出生体重风险增加相关;父母双方罹患地贫比父母单方罹患地贫发生新生儿早产(趋势检验χ2=22.72,P<0.001)以及低出生体重(趋势检验χ2=34.03,P<0.001)的风险更高。结论 父母双方罹患地贫或任意一方罹患地贫均可增加新生儿早产和低出生体重的风险,且父母双方罹患地贫发生早产和低出生体重的风险更高。
English Abstract:
      Objective To investigate the association between the preterm birth and low birth weight and parental thalassemia. Methods Pregnant women and their husbands receiving prenatal examination in local hospitals or maternal and child health centers in Jingxi and Debao in Guangxi from January to December 2017 were selected as study subjects. A total of 758 pregnant women with pregnancy outcomes and their husbands, who were both or alone diagnosed with thalassemia through thalassemia gene detection, were selected as case group and 758 pregnant women with pregnancy outcomes and their husbands, who were negative in thalassemia gene detection and hemoglobin electrophoresis test were selected as control groups. The case group were further divided into mother group, father group and both mother and farther group. Clinical and pregnancy outcome data of the study subjects were collected for the analysis on the association between parental thalassaemia and preterm birth or low birth weight by the independent sample t test, χ2 test and Cox regression analysis. Results The incidence of preterm birth in case group and control group was about 6.5% and 1.6% and the incidence of low birth weight in case group and control group was about 7.3% and 0.8%. After adjusting for possible confounding factors, Cox regression analysis results showed that mother suffering from thalassemia (aRR=3.45, 95%CI:1.35-8.81, P=0.010), fathers suffering from thalassemia (aRR=4.93, 95%CI:2.16-11.21, P<0.001) and both mother and farther suffering from thalassemia (aRR=5.13, 95%CI:2.62-10.04, P<0.001) were associated with preterm birth. Mother suffering from thalassemia (aRR=12.98, 95%CI:4.91-34.30, P<0.001), fathers suffering from thalassemia (aRR=9.40, 95%CI:3.40-25.95, P<0.001) and both mother and farther suffering from thalassemia (aRR=10.74, 95%CI:4.44-26.00, P<0.001) were associated with low birth weight. The newborn whose parent all suffered from thalassemia had higher risks for preterm birth (χ2=22.72, P<0.001)and low birth weight (χ2=34.03, P<0.001) compared with those only with mother or father suffering from thalassemia. Conclusion Parental thalassaemia, including both sides and single side, might increase the risks of preterm birth and low birth weight for newborn, and the risks might be higher in newborn with both mother and father suffering from thalassaemia.
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