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孕前丙氨酸氨基转移酶异常、高龄生育与早产低出生体重关联的队列研究

庾静云 张新建 姜碧 刘宇炜 梁煜 曾思良 甘展鹏

庾静云, 张新建, 姜碧, 刘宇炜, 梁煜, 曾思良, 甘展鹏. 孕前丙氨酸氨基转移酶异常、高龄生育与早产低出生体重关联的队列研究[J]. 中华疾病控制杂志, 2024, 28(3): 345-350. doi: 10.16462/j.cnki.zhjbkz.2024.03.016
引用本文: 庾静云, 张新建, 姜碧, 刘宇炜, 梁煜, 曾思良, 甘展鹏. 孕前丙氨酸氨基转移酶异常、高龄生育与早产低出生体重关联的队列研究[J]. 中华疾病控制杂志, 2024, 28(3): 345-350. doi: 10.16462/j.cnki.zhjbkz.2024.03.016
YU Jingyun, ZHANG Xinjian, JIANG Bi, LIU Yuwei, LIANG Yu, ZENG Siliang, GAN Zhanpeng. A cohort study on the relationship between women′s pre-pregnancy abnormal alanine aminotransferase, advanced age delivery and preterm low birth weight of newborns[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(3): 345-350. doi: 10.16462/j.cnki.zhjbkz.2024.03.016
Citation: YU Jingyun, ZHANG Xinjian, JIANG Bi, LIU Yuwei, LIANG Yu, ZENG Siliang, GAN Zhanpeng. A cohort study on the relationship between women′s pre-pregnancy abnormal alanine aminotransferase, advanced age delivery and preterm low birth weight of newborns[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(3): 345-350. doi: 10.16462/j.cnki.zhjbkz.2024.03.016

孕前丙氨酸氨基转移酶异常、高龄生育与早产低出生体重关联的队列研究

doi: 10.16462/j.cnki.zhjbkz.2024.03.016
基金项目: 

广东省医学科学技术研究基金 B2020071

详细信息
    通讯作者:

    曾思良,E-mail:420861858@qq.com

  • 中图分类号: R173

A cohort study on the relationship between women′s pre-pregnancy abnormal alanine aminotransferase, advanced age delivery and preterm low birth weight of newborns

Funds: 

Guangdong Medical Science and Technology Research B2020071

More Information
  • 摘要:   目的  探讨母亲孕前丙氨酸氨基转移酶(alanine aminotransferase, ALT)异常、高龄生育与新生儿早产低出生体重的关联。  方法  采用历史性队列研究,选取2015年1月―2020年9月在东莞市参加免费婚前健康检查和孕前优生健康检查项目的育龄女性,获取受检对象基本情况及相关检查结果,追踪随访获取其妊娠结局情况。采用多因素logistic回归分析母亲孕前ALT异常、高龄生育对新生儿早产低出生体重发生的影响,并进行亚组和敏感性分析检验结果的稳定性。  结果  共纳入23 620名母亲,新生儿早产低出生体重发生率为2.90%。多因素logistic回归分析结果显示,校正了协变量后母亲孕前ALT异常(RR=1.527, 95% CI: 1.133~2.016, P=0.004)、高龄生育(RR=1.257, 95% CI: 1.006~1.562, P=0.042)均可增加新生儿早产低出生体重发生风险。各亚组的效应值方向未发生改变,且组间异质性差异均无统计学意义(均P>0.05)。依次剔除了母亲孕前血糖(blood glucose, GLU)异常和孕前乙型肝炎表面抗原(hepatitis B surface antigen, HBsAg)阳性人群,效应值较为稳定。  结论  母亲孕前ALT异常和高龄生育与新生儿早产低出生体重相关。
  • 图  1  样本筛选流程图

    ALT: 丙氨酸氨基转移酶。

    Figure  1.  Sample screening flow chart

    ALT: alanine aminotransferase.

    图  2  亚组分析和敏感性分析森林图

    GLU: 血糖; HBsAg: 乙型肝炎表面抗原; ALT: 丙氨酸氨基转移酶。

    Figure  2.  Forest map of subgroup analysis and sensitivity analysis

    GLU: blood glucose; HBsAg: hepatitis B surface antigen; ALT: alanine aminotransferase.

    表  1  新生儿早产低出生体重影响因素

    Table  1.   The influencing factors of preterm low birth weight of newborns

    特征Feature 总人数 Total (n=23 620) 早产低出生体重儿 Preterm low birth weight (n=684) χ2值value P值value
    婴儿性别Infant gender 0.316 0.574
      男Male 12 319(52.16) 349(2.83)
      女Female 11 301(47.84) 335(2.96)
    母亲民族Mother′s ethnic 0.004 0.949
      汉族Han nationality 23 355(98.88) 677(2.90)
      少数民族Minority nationality 265(1.12) 7(2.64)
    母亲户口所在地Mother′s household registration location 0.802 0.371
      本地市Local city 19 751(83.62) 581(2.94)
      外地市Non local cities 3 869(16.38) 103(2.66)
    母亲分娩史Mother′s delivery history 2.209 0.137
      无None 13 069(55.33) 398(3.05)
      有Had 10 551(44.67) 286(2.71)
    孕前GLU异常Pre-pregnancy abnormal GLU 1.056 0.304
      否No 21 971(93.02) 629(2.86)
      是Yes 1 649(6.98) 55(3.34)
    孕前HBsAg阳性Pre-pregnancy HBsAg positive 0.128 0.721
      否No 22 025(93.25) 635(2.88)
      是Yes 1 595(6.75) 49(3.07)
    孕前ALT异常Pre-pregnancy abnormal ALT 9.597 0.002
      否No 22 386(94.78) 630(2.81)
      是Yes 1 234(5.22) 54(4.38)
    分娩方式Delivery method 25.214 <0.001
      阴道分娩Vaginal delivery 15 471(65.50) 386(2.50)
      剖宫产分娩Cesarean section delivery 8 149(34.50) 298(3.66)
    高龄生育Advanced age delivery 3.053 0.081
      否No 19 562(82.82) 549(2.81)
      是Yes 4 058(17.18) 135(3.33)
    注:GLU, 血糖; HBsAg, 乙型肝炎表面抗原; ALT, 丙氨酸氨基转移酶。①以人数(占比/%)表示。
    Note: GLU, blood glucose; HBsAg, hepatitis B surface antigen; ALT, alanine aminotransferase.①Number of people(proportion/%).
    下载: 导出CSV

    表  2  母亲孕前ALT异常、高龄生育与新生儿早产低出生体重的关系

    Table  2.   Relationship between women′s pre-pregnancy abnormal ALT, advanced age delivery and preterm low birth weight of newborns

    暴露因素Exposure factors 早产低出生体重Preterm low birth weight
    RR value (95% CI) P value aRR值value (95% CI) aP值value
    孕前ALT异常Pre-pregnancy abnormal ALT 0.002 0.004
      否No 1.000 1.000
      是Yes 1.580(1.177~2.079) 1.527 (1.133~2.016)
    高龄生育Advanced age delivery 0.072 0.042
      否No 1.000 1.000
      是Yes 1.192(0.981~1.438) 1.257 (1.006~1.562)
    注:GLU, 血糖; HBsAg, 乙型肝炎表面抗原; ALT, 丙氨酸氨基转移酶。①未校正;②校正了婴儿性别、母亲孕前HBsAg阳性、分娩方式、高龄生育、母亲分娩史、孕前GLU异常;③校正了婴儿性别、母亲孕前HBsAg阳性、分娩方式、孕前ALT异常、母亲分娩史、孕前GLU异常。
    Note: GLU, blood glucose; H BsAg, hepatitis B surface antigen; ALT, alanine aminotransferase.① Not corrected; ② Corrected for infant gender, pre-pregnancy HBsAg positive of mother, delivery method, advanced age delivery, mother′s delivery history, and pre-pregnancy abnormal GLU; ③ Corrected for infant gender, pre-pregnancy HBsAg positive of mother, delivery method, pre-pregnancy abnormal ALT, mother′s delivery history, and pre-pregnancy abnormal GLU.
    下载: 导出CSV
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  • 收稿日期:  2022-10-26
  • 修回日期:  2023-01-17
  • 网络出版日期:  2024-04-08
  • 刊出日期:  2024-03-10

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