台灣地區嬰兒出生體重與妊娠週數分佈之長期變化趨勢

Long-term Secular Trends in Birth Weight and Gestational Age Among Live Births in Taiwan

李佩珍(Pei-Chen Lee) ； 郭素珍(Su-Chen Kuo) ； 鄧森文(Sen-Wen Teng) ； 呂宗學(Tsung-Hsueh Lu) ； 李中一(Chung-Yi Li)

《台灣公共衛生雜誌》 22卷5期 (2003/10) Pp. 376-385

https://doi.org/10.6288/TJPH2003-22-05-12

摘要

Objectives: To analyze the calendar-year specific distributions of birth weight and gestational age among live births in Taiwan for the years 1982, 1987, 1992, and 1997. Methods: After excluding implausible gestational age and birth weight, we calculated calendar or birth characteristics specific means and standard deviations of gestational age and birth weight. We also estimated the calendar-year specific rates of low birth infants (＜2500 grams) and pre-term birth (＜37 completed gestational weeks). Certain infant and maternal characteristics suspected of being associated with birth weight or gestational age were also calculated. We finally draw a gestation specific birth weight curve for the years 1982 and 1997, respectively. Results: The mean birth weight decreased by 3.2% (105 grams) between 1982 and 1997, and the rate of low birth weight of infant increased by 33.3%. The gestational weeks also reduced by 2.3% (0.9 weeks) and the rate of pre-term birth increased dramatically by 230% (2.6%-6.3%). Triplets or higher births showed the most reduction in both birth weight (16.8%) and gestational age (8.5%). Between the study period, the sex ratio and birth order distribution showed little variation whereas the proportion of mothers aged 35 or more and that of multiple births increased substantially by 3.8 and 13 times, respectively. Conclusions: The reduction of health care services and completeness of birth weight and gestation during the study period is possibly related to improvement in both health care services and completeness of birth registration. An increase in multiple births and a higher survival rate of very pre-term birth (＜34 weeks) might also contribute to the reduction of birth weight in recent years.

關鍵字

妊娠週數 ； 出生體重 ； 早產 ； 低出生體重 ； 出生登記

並列摘要

Objectives: To analyze the calendar-year specific distributions of birth weight and gestational age among live births in Taiwan for the years 1982, 1987, 1992, and 1997. Methods: After excluding implausible gestational age and birth weight, we calculated calendar or birth characteristics specific means and standard deviations of gestational age and birth weight. We also estimated the calendar-year specific rates of low birth infants (＜2500 grams) and pre-term birth (＜37 completed gestational weeks). Certain infant and maternal characteristics suspected of being associated with birth weight or gestational age were also calculated. We finally draw a gestation specific birth weight curve for the years 1982 and 1997, respectively. Results: The mean birth weight decreased by 3.2% (105 grams) between 1982 and 1997, and the rate of low birth weight of infant increased by 33.3%. The gestational weeks also reduced by 2.3% (0.9 weeks) and the rate of pre-term birth increased dramatically by 230% (2.6%-6.3%). Triplets or higher births showed the most reduction in both birth weight (16.8%) and gestational age (8.5%). Between the study period, the sex ratio and birth order distribution showed little variation whereas the proportion of mothers aged 35 or more and that of multiple births increased substantially by 3.8 and 13 times, respectively. Conclusions: The reduction of health care services and completeness of birth weight and gestation during the study period is possibly related to improvement in both health care services and completeness of birth registration. An increase in multiple births and a higher survival rate of very pre-term birth (＜34 weeks) might also contribute to the reduction of birth weight in recent years.

並列關鍵字

gestational age ； birth weight ； pre-term birth ； low birth weight ； birth registry

參考文獻

Alexander, G. R., De Caunes, F., Hulsey, T. C., Tompkins, M. E., Allen, M.(1992).Validity of Postnatal Assessments of Gestational Age: A Comparison of the Method of Ballard et al. and Early Ultrasonography.Am J Obstet Gynecol.166

Alexander, G. R., Tompkins, M. E., Cornely, D. A.(1990).Gestational Age Reporting and Preterm Delivery.Public Health Rep.105

Arbuckle, T. E., Wilkins, R., Sherman, G. J.(1993).Birth Weight Percentiles by Gestational Age in Canada.Obstet Gynecol.81

Blondel, B., Kogan, M. D., Alexander, G. R.(2002).The Impact of the Increasing Number of Multiple Births on the Rates of Pretermbirth and Low Birthweight: An International Study.Am J Public Health.92

Branum, A. M., Schoendorf, K. C.(2002).Changing Patterns of Low Birthweight and Preterm Birth in the United States, 1981-1998.Paediatr Perinat Epidemiol.16