背景:早產與低出生體重是嬰兒期疾病率與死亡率的重要決定因素。本研究的目的在估計台灣地區早產(懷孕週數小於37週)與低出生體重(出生體重小於2500公克)之發生率,以及分別探討早產與低出生體重的危險因子。 方法:本研究樣本為來自一為期2年探討嬰兒疾病率與死亡率追蹤研究之3600名新生嬰兒,這些嬰兒為台灣地區1996年2月12-16日所有懷孕滿20週或以上之新生嬰兒。本研究採用面對面訪視的方法蒐集可能影響早產與低出生體重之危險因子相關訊息,並利用複邏輯斯迴歸估計早產與低出生體重發生之勝算比。 結果:早產與低出生體重的發生率估計值分別為7.5%與6.7%。青少女與35歲以上母親、非已婚狀態母親、非單胞胎、產前照護不足、以及懷孕期間之罹病與合併症是影響早產與低出生體重發生的共同危險因子。此外,人工流產經驗也會增加早產發生的危險性,而初產婦、母親身高小於158公分、與小於37週的懷孕期則是另外三個會增加低出生體重危險性的因素。 結論:本研究發現某些人口學與生殖相關變項均會影響早產與低出生體重發生的危險性。本研究數據建議應針對同時具有早產與低出生體重危險因素的高危險群孕婦進行更為積極有效的介入工作,例如更為密集的產前照護。
Background: Preterm birth and low birth weight (LBW) are major determinants of infant morbidity and mortality. The purpose of this study was to estimate the incidence rate of preterm birth (< 37gestatoinal weeks) or LBW (< 2500 grams) infants, and to examine the risk factors associated with preterm birth or LBW infants in Taiwan. Methods: The study sample was consisted of 3,600 neonates of a 2-year follow up study that investigated infant morbidity and mortality. The study subjects were neonates born to all mothers who gave birth(s) with a gestational age of 20 weeks or more between February 12 and 16 in Taiwan in 1996. A face-to-face interview was administered to collect the information on potential predictors for preterm birth or LBW infants. Multiple logistic regression model was applied to estimate the adjusted odds ratio (OR) of preterm birth or LBW in relation to the selected potential predictors. Results: The incidence rate of preterm birth and LBW infants was estimated to be 7.5% and 6.7%, respectively. Teen or older (≧35 years) mothers, unwedded mothers, non-singleton births, less or too much prenatal cares, and complicated pregnancies were common significant predictors for preterm birth and LBW infants. Additionally, the risk of preterm birth was also significantly increased with a history of induced abortion, whereas an elevated risk of LBW infants was significantly associated with nulliparity, a maternal body height of 158 cm or less, short gestational age (<37 weeks), and inadequate weight gain for mothers during pregnancy. Conclusion: Both demographic and reproductive factors influenced the risks of preterm birth and LBW infants. The results suggest the need among women with common risk factors for preterm birth or LBW infants for effective targeted services and programs such as intense prenatal cares.
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