產婦年齡與不良懷孕結果的探討－花蓮縣三年生產記錄分析

Maternal Age and Adverse Pregnancy Outcomes - Analysis of Birth Records from 1997 to 1999 in Hualien County

李燕鳴(Yin-Ming Li) ； 傅振宗(Chen-Chung Fu)

《慈濟醫學雜誌》 13卷2期 (2001/06) Pp. 95-103

https://doi.org/10.6440/TZUCMJ.200106.0095

摘要

目的：分析花蓮縣各鄉鎮市區及不同年齡產婦生育早產、低出生體重和先天性缺陷兒的比例及差弱。病人與方法：採用花蓮縣1997年至1999年三年醫療診所申報的生育記錄；另查臺閩人口統計所登錄同期各區之15-19歲(未成年)女性人口數及該年齡生產的新生兒數，以百分比、卡方檢定和勝算比分析不同年齡產婦不良懷孕結果之差異。結果：枓據12,438份出生記錄分析，有現醫療登錄之未成年生育較戶政記錄低出0.1%，全體中未成年產婦佔9.2%，高齡產婦(年齡在35歲及以上)佔7.8%；山地鄉之未成年生育率是花蓮市的三至七倍。全花蓮縣早產、低出生體重和有先天性缺陷兒的比例分別是8.2%、7.4%和0.7%，但以在山地鄉最高，三項不良結果之比例分別是11.2%，1.4%和0.8%；未成年組之新生兒11.5%是早產，20.4%是低出生體0.7%有先天性缺陷；高齡組之新生兒有9.4%早產，9.0%是低出生體重和1.1%有先天性缺陷。以年齡為20至34歲產婦為對照，未成年與高齡產婦之新生兒是早產或低出生體重的相對風險高出約1.3-1.5個。結論：戶政與醫療生育記錄之差異需進一步探討，未成年及高齡懷孕不良結果高於一般育齡者，山地鄉之未成年生育問題尤其嚴重，該區孕產婦之健康照顧及新生兒的緊急醫療服務有高度的需求。

關鍵字

未成年 ； 高齡產婦 ； 早產 ； 低出生體重 ； 花蓮縣

並列摘要

Objectives: To study the proportion of premature birth, low birth weight and congenital abnormalities among different maternal ages. Patients and Methods: Birth records from 1997 to 1999, registered at the health department were collected. Statistics on population and births to mothers between 15 and 19 years old in Hualien County were checked at the Ministry of Interior. Results: The health department registered 20.1% of fewer births to teenage mothers than the Ministry of Interior. Of 12,438 birth records, the proportion of young mothers (less than 20 years old) was 9.2% and older mothers (35 years old and above) was 7.8%. In aboriginal villages, the birth rates were 3 to 7 times higher than in Hualien City. In Hualien County, the adverse pregnancy outcomes were as follows: Preterm birth 8.2%, low birth weight 7.4% and congenital obnormalities 0.7%. The proportions of preterm birth, low birth weight, and congenital abnormalities were 11.2%, 1.4% and 0.8%, respectively in aboriginal villages. Young maternal age had the highest rates of adverse pregnancy outcomes, with preterm birth 11.5%, low birth weight 20.4% and congenital abnormalities 0.8%. Older mothers also had higher rates of preterm birth (9.4%), low birth weight (9.0%) and congenital abnormalities (1.1%). Babies born to young or older mothers had a higher risk of being preterm or low birth weight (odds ratios 1.3 to 1.5, P＜0.01). Conclusions: The discrepancy between teenage births registered at the health department and the Ministry of Interior should be investigated. Teenage pregnancy is common in aboriginal villages. Antenatal and intensive newborn care systems are needed in the community.

並列關鍵字

teenage ； old aternal age ； preterm ； low birth weight ； Hualien County