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中国循证儿科杂志

中国循证儿科杂志 ›› 2019, Vol. 14 ›› Issue (1): 35-39.

• 论著 • 上一篇    下一篇

基于22 455名8~10月龄婴儿发育筛查的早产与低出生体重因素交互作用的巢式病例对照研究

喜雷1,3，黄玥2,3，韩娜1，陈春屹2，王银平2，高雅晴2，周虹2   

  1. 1 北京市通州区妇幼保健院 北京，101100；2 北京大学公共卫生学院妇幼卫生学系 北京，100191；3 共同第一作者
  • 收稿日期:2018-09-20 修回日期:2018-12-24 出版日期:2019-02-25 发布日期:2019-02-25
  • 通讯作者: 周虹

Nested case-control study on interaction effect between preterm birth and low birth weight based on the development screening result of 22 455 infants aged 8 to 10 months

XI Lei1,  HUANG Yue2, HAN Na1, CHEN Chun-yi2,  WANG Yin-ping2, GAO Ya-qing2, ZHOU Hong2   

  1. 1 Maternal and Child Health Care Hospital of Tongzhou District, Beijing 101100, China; 2 Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China; 3 Co-first author
  • Received:2018-09-20 Revised:2018-12-24 Online:2019-02-25 Published:2019-02-25
  • Contact: ZHOU Hong

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摘要： 目的 分析早产和低出生体重因素对婴儿发育的影响，重点探索二者对婴儿发育的潜在交互作用。方法 通过北京市通州区妇幼保健院电子信息系统收集2013年9月至2017年12月于8~10月龄时接受了丹佛发育筛查（DDST）的婴儿的相关资料，应用巢式病例对照研究的方法，将DDST筛查结果为“可疑”或“异常”的儿童作为病例组，将DDST筛查结果为“正常”的儿童作为对照组，通过卡方检验对婴儿的发育情况及影响因素进行分析，通过单因素和多因素非条件logistic回归模型分析早产与低出生体重因素对婴儿发育的可能影响，利用相加交互作用和相乘交互作用模型探索早产+低出生体重联合作用与儿童早期发育的关系。结果 本研究共纳入22 455名8~10月龄婴儿，DDST可疑/异常比例为2.6%。孕周越小、出生体重越低，婴儿在8~10月龄时出现DDST可疑/异常的风险越高。交互作用分析显示，早产与低出生体重因素对婴儿DDST可疑/异常存在相加交互作用（RERI=2.55, 95%CI: 0.54-4.55），未发现相乘交互作用（OR=1.50, 95%CI：0.68-3.30）。结论 早产与低出生体重因素对婴儿发育存在相加交互作用，未发现相乘交互作用。对早产合并低出生体重儿的早期发育问题应给予更多关注。

Abstract: Objective To analyze the effects of preterm birth and low birth weight on infant development, and to explore the potential interaction effect of preterm birth and low birth weight on the development of infants. Methods Data of infants at the age of 8 to 10 months receiving Denver Development Screening Test (DDST) from September 2013 to December 2017 in Tongzhou District of Beijing City were collected through the electronic information system of Maternal and Child Health Care Hospital of Tongzhou District. Using the method of nested case-control study, the children with DDST screening results of "suspicious" or "abnormal" were taken as the case group, and the children with DDST screening results of "normal" were taken as the control group. Chi-square test was used to analyze the development of infants and its influencing factors. Univariate and multivariate unconditional logistic regression models were used to analyze the possible influence of preterm birth and low birth weight on infant development. The interaction effect of preterm birth and low birth weight on infant development was investigated by using the additive and multiplicative interaction models. Results A total of 22 455 infants aged from 8 to 10 months were included in this study and the prevalence of suspicious/abnormal DDST results was 2.6%. The infant with younger gestational age or lower birth weight might have higher risk of suspicious/abnormal DDST results at the age of 8 to 10 months. In interaction analysis, preterm birth and low birth weight were observed to have additive interaction to the infant development (RERI=2.55, 95%CI: 0.54-4.55), but their multiplicative interaction was not observed (OR=1.50，95%CI：0.68-3.30). Conclusion There was an additive interaction between preterm birth and low birth weight, and no multiplicative interaction was found between these two factors. It should be paid more attention on the early development of infants with preterm birth and low birth weight.