强化干预计划实施后的十年间，巨型畸形发生率有所下降

Q1 Social Sciences Global Transitions Pub Date : 2024-01-01 DOI:10.1016/j.glt.2024.08.001

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摘要

研究收集了中国北京妇产医院单胎孕妇的年度分娩数据（2014-2023 年）。第一阶段干预包括孕期营养评估和生活方式管理，第二阶段增加了孕产妇体重和胎儿生长监测，并在必要时进行强化管理。干预前的新生儿（2014-2016 年）作为对照。结果在126824名孕妇中，大畸形发生率在十年间从7.11%降至4.15%，干预后下降速度加快（第一和第二阶段的斜率p=0.050和0.004），主要原因是妊娠体重增加过多（调整后的人口可归因风险=28.6%，格兰杰原因p=0.0001）。结论在强化干预计划实施后的十年间，畸形儿患病率显著下降。

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The reduction in macrosomia prevalence over a decade following the intensive intervention programs

Objective

To assess changes in macrosomia prevalence following a two-stage lifestyle intervention program.

Methods

The study collected annual delivery data from singleton pregnant women at the Beijing Obstetrics and Gynecology Hospital in Beijing, China (2014–2023). The first intervention stage involved nutritional assessment and lifestyle management in pregnancy, and maternal weight and fetal growth monitoring were added in the second stage, with intensive management as necessary. Pre-intervention births (2014–2016) served as controls. The change in macrosomia and low birth weight prevalence following the intervention was assessed by an interrupted time series analysis.

Results

Among 126,824 pregnant women, macrosomia prevalence decreased from 7.11 % to 4.15 % over ten years, with an accelerated decrease post-intervention (p for slope = 0.050 and 0.004 for the first and second stages), primarily contributed by the reduction in excessive gestational weight gain (adjusted population attributable risk = 28.6 %, p for Granger cause = 0.0001). The change in the increasing rate of low-birth-weight prevalence was non-significant.