台北市立婦幼綜合醫院低體重新生兒發生原因之研究

低體重新生兒由於許多器官、功能或結構發展不完全，容易導致死亡、永久性的傷害以及併發症的產生，因此低體重新生兒的發生率直接或間接影響社會資源的分配。若低體重新生兒發生率高，所需醫療成本將大幅提高，相對犧牲其他資源適當的使用，未來的社會成本也相對提高。本研究嘗試找出低體重新生兒發生之原因，以預防勝於治療為出發點，在婦女懷孕前給予足夠的教育，在懷孕後給予完善的醫療照顧。本研究以邏輯斯迴歸(Logistic Regression Analysis)分析，發現懷孕母親年齡在20~40歲、25~29歲、30~34歲、35歲以上者生出低體重新生兒的機率皆比年齡在20歲以下的懷孕母親低，其發生率分別為0.118、0.112、0.084、0.063倍。懷孕期間增加體重小於10公斤的母親，生出低體重新生兒的機率較高，是體重增加10~14公斤者的1.794倍。母親唐氏症篩檢異常者，生出低體重新生兒的機率是篩檢正常者的2.454倍。懷孕期間曾住院安胎者，是不曾住院安胎者的2.589倍。曾生過低體重新生兒者，是未曾生過低體重新生兒者的32.18倍。曾生過早產兒者，是未曾生過早產兒者的3.21倍。新生女嬰比男嬰容易成為低體重的機率為1.803倍。多胞胎的新生兒比非多胞胎容易成為低體重的機率為14.553倍。早產的新生兒比非早產兒容易成為低體重的機率為21.795倍。

關鍵字

低體重新生兒；早產兒；唐氏症篩檢

並列摘要

Many low birthweight newborns easily lead to death or permanent damage due to incomplete development of functions or structures of organs. Therefore, the prevalent rate of the low birthweight newborns affects the distribution of the social resources, both directly and indirectly. The higher the prevalent rate, the higher the medical costs as well as the social costs. It would also sacrifices some resources that could be used more properly. This case study of Taipei Municipal Women's and Children's Hospital examined numbers of possible causes of the low birthweight deliveries. This paper suggests that prevention is better than remedies. Women should be better-educated about conception, pregnancy, and birth before they become pregnant; and be given sufficient medical care during and after pregnancy. The result of logistic regression analysis in this study showed that the rate of low birthweight delivery for mothers with age from 20 to 24, 25 to 29, 30 to 34, or 35 and older, is statistically significantly lower than mothers under 20 years old. Compared with teenage mothers, the rates of low birthweight delivery are 0.118, 0.112, 0.084, and 0.063, respectively. In addition, mothers who gained less than 10 kilograms during their pregnancy are 1.794 times as likely as those mothers who gained 10-14 kilograms to have low birthweight newborns. Similarly, pregnant women with abnormal Down syndrome screening is 2.454 times as likely as those women with normal Down syndrome screening to deliver low birthweight babies. The probability of low birthweight delivery for mothers who had been admitted for treatment of threaten abortion during pregnancy is 2.589 times as that for those who had not Mothers who ever had low birthweight newborns axe 32.180 times as likely to have low birthweight newborns as mothers who have not had. By the same token, mothers who had premature babies are 3.210 times as likely, as those who have not had, to deliver low birthweight babies. Baby girls are 80.3% more likely than baby boys to be low birthweight. The probability of low birthweight for newborns from multiple pregnancies is 14.553 times as that for those from single pregnancies. Premature newborns are 21.795 times as likely as their counterparts to be low binhweight.