Correlation between the infants of large for gestational age and the age interval of delivery age and menarche age
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摘要:
目的 探讨孕妇分娩年龄和初潮年龄间隔年数与大于胎龄儿(large for gestational age, LGA)的相关性。 方法 选取2015年6月—2018年4月在广西壮族自治区百色市5个县孕早期建卡产检2 032名孕妇为研究对象。分析孕妇间隔年龄与LGA发生的相关性，接收者操作特征(receiver operating characteristic, ROC)曲线分析孕妇间隔年龄在预测LGA发生中的作用。 结果 队列随访至2 032名孕妇分娩，其中发生LGA 67例，发生率为3.3%。LGA组孕妇分娩年龄、间隔年龄和BMI较非LGA组大(均有P < 0.05)。相关性分析中，校正混杂因素后，孕妇间隔年龄与出生体重无相关(P=0.178)，但间隔年龄≥30岁的孕妇LGA发生风险是间隔年龄 < 10岁的29.214倍(P=0.018)。ROC曲线分析显示，孕妇间隔年龄预测总体、分娩女婴的AUC分别为0.585、0.644，孕妇间隔年龄预测LGA的最佳截断点均为13岁。 结论 孕妇分娩年龄和初潮年龄间隔年数与LGA发生有关，间隔年数越大则LGA发生风险越大。分娩年龄和初潮年龄间隔在女婴LGA发生预测中效果更好。 Abstract:Objective To explore the correlation between the infants of large for gestational age(LGA) and the age interval of delivery age and menarche age. Methods A total of 2 032 pregnant women were enrolled from June 2015 to April 2018 in the five Maternal and Child Health Care Institutions in Baise City, Guangxi. The association between the infants of LGA risk and maternal interval age was analyzed, and the efficiency of maternal interval age in predicting LGA was analyzed by receiver operating characteristic (ROC) curve. Results During the follow-up of 2 032 pregnant women, the number of 67 cases had LGA, the incident rate was 3.3%. The delivery age, interval age and BMI of pregnant women in LGA group were higher than those in non-LGA group (all P < 0.05). In correlation analysis, after adjusting for confounding factors, there was no association between maternal interval age and birth weight (P=0.178), but the risk of LGA in pregnant women with maternal interval age ≥ 30 years was 29.214 times higher than that with maternal interval age < 10 years (P=0.018). The ROC curve analysis showed that the AUC of the overall prediction of maternal interval age and the delivery of female infants were 0.585 and 0.644, respectively, and the best cutoff point for the prediction of LGA by maternal interval age was 13 years old. Conclusion The longer the interval between delivery age and menarche age is, the higher the risk of LGA. The interval between delivery age and menarche age is a good predictor of LGA in female infant. -
Key words:
- Large for gestational age /
- Menarche age /
- Delivery age /
- Birth cohort /
- Pregnancy outcome
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表 1 非LGA组和LGA组孕妇人口学特征比较
Table 1. Comparison of demographic characteristics between non-LGA and LGA pregnant women
变量 非LGA组(n=1965) LGA组(n=67) t/χ2 P 初潮年龄(岁) 13.65±1.43 13.72±1.20 -0.370 0.711 分娩年龄(岁) 28.17±5.56 29.97±5.44 -2.602 0.009 间隔年龄(岁) 14.52±5.55 16.25±5.34 -2.514 0.010 BMI(kg/m2) 20.60±2.95 21.83±2.99 -3.366 0.001 民族 汉族 142(7.2) 4(6.0) 1.454 0.483 壮族 1 713(87.2) 57(85.1) 其他 110(5.6) 6(9.0) 职业 农民 383(19.5) 11(16.4) 0.391 0.532 其他 1 582(80.5) 56(83.6) 孕早期饮酒史 否 1 808(92.0) 64(95.5) 1.102 0.294 是 157(8.0) 3(4.5) 孕早期吸烟或接触二手烟 否 942(47.9) 34(50.7) 0.205 0.651 是 1 023(52.1) 33(49.3) 孕次 首次 520(26.5) 13(19.4) 1.669 0.196 多次 1 445(73.5) 64(80.6) 产次 初产妇 966(49.2) 26(38.8) 2.780 0.095 经产妇 999(50.8) 41(61.2) 妊娠高血压 无 1 865(94.9) 65(97.0) 0.241 0.623 有 100(5.1) 2(3.0) 妊娠糖尿病 无 1 871(95.2) 61(91.0) 2.410 0.121 有 94(4.8) 6(9.0) 婴儿性别 男 1 057(53.8) 44(65.7) 3.684 0.055 女 908(46.2) 23(34.3) 
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表 2 孕妇间隔年龄与新生儿出生体重的相关性
Table 2. Correlation between maternal interval age and neonatal birth weight
变量 模型I 模型II β 95% CI P β 95% CI P 间隔年龄(岁) 9.633 6.269~12.997 < 0.001 7.676 -3.500~18.852 0.178 注：模型I：未校正混杂因素; 模型II：校正孕前BMI、孕次、产次、妊娠糖尿病、出生孕周、婴儿性别和分娩年龄。
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表 3 孕妇间隔年龄对LGA发生风险的影响
Table 3. Effect of maternal interval age on LGA risk
变量 模型I 模型II β 95% CI P β 95% CI P 间隔年龄(岁) <10 1.000 - - 1.000 - - 10~<20 2.677 1.054~6.800 0.038 2.373 0.611~9.225 0.212 20~＜30 3.663 1.337~10.034 0.012 4.501 0.902~22.461 0.067 ≥30 18.800 1.771~199.563 0.015 29.214 1.773~482.273 0.018 注：模型I：未校正混杂因素; 模型II：校正孕前BMI、孕次、产次、妊娠糖尿病、出生孕周、婴儿性别和分娩年龄。
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表 4 孕妇间隔年龄预测LGA发生效能
Table 4. Efficacy of maternal interval age in predicting LGA
变量 AUC P 最佳截断点 灵敏度(%) 特异度(%) 间隔年龄(岁) 总体 0.585 0.010 13 86.96 44.05 男婴 0.550 0.266 19 29.55 82.31 女婴 0.644 < 0.001 13 86.96 44.05
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