孕期职业应激和不良生活事件与低体重儿的关系

目的 探讨孕期职业应激和不良生活事件对低体重儿的影响.方法 以某省2家妇幼保健院出生的孕周≥28周且<42周、体重<2500 g的单胎、活产、无畸形的438例低体重儿为病例组,按1:1匹配的原则,选择同一家医院分娩、新生儿同性别、分娩时间不超过1周的438例足月正常体重儿为对照组,进行病例对照研究.由培训合格的调查员对其母亲进行调查,内容包括产妇一般情况、职业应激和孕期不良生活事件等.在控制产妇年龄、职业、文化程度和家庭月人均收入等因素后,应用条件logisfic回归探讨孕期职业应激和不良生活事件对低体重儿的影响.结果 与低技术使用度和低工作决策相比,拥有高技术使用度(OR=0.62;95%CI=0.43～0.91)和高工作决策(OR=0.67;95%CI=0.46～0.97)可明显降低低体重儿的危险性.与孕期未发生生活事件的孕妇相比,在孕中期生活事件指数3分及以上(OR:18.85:95%CI=1.58～225.02)、孕晚期生活事件指数1分(OR=2.67;95%CI=1.14～6.28)、整个孕期生活事件指数2分(OR=2.80;95%CI=1.04～7.52)和≥3分(OR=2.94;95%CI=1.22-7.09)是低体重儿的危险因素.结论 孕期发生不良生活事件可影响低体重儿的发生,且不同孕期发生的不良生活事件对低体重儿的影响存在差异.

Relationship of occupational stress and negative life events with low birth weight

Objective To explore the influence of occupational stress and negative life events on low birth weight (LBW). Methods 1:1 matched case-control study was employed, in which 438 singleton LBW infants with birth weight less than 2500 g (their pregnancy term being 28 to 42 weeks ) served as case group while 438 with singleton term normal birth weight served as control group matched by sex,delivery time and hospital. All of their mothers were inquired by well trained investigators about their socio-demographic characteristics,occupational stress,and negative life events occurring in different pregnancy tenn. After controlling for mother's age, occupation, education level and family income, conditional logistic regression was employed to asses the influence of occupational stress and negative life events on LBW. Results Compared with those with low technical skill utilization and low job decision, mothers with high technical skill utilization (OR=0.62;95%CI=0.43～0.91) and high job decision (OR=0.67;95%CI=0.46～0.97) significantly decreased the risk of laboring LBW. Compared with those not exposed to negative life events, mothers with negative life event scorebeing ≥ 3 in the middle three months of pregnancy( OR=18.85;95%CI=1.58-225.02),with negative life event score being 1 in the later three months of pregnancy (OR=2.67;95% Cl=1.14～6.28),with negative life event score being 2( OR=2.80;95%CI=1.04～7.52 and ≥ 3 in the whole time of pregnancy( OR=2.94;95%CI=1.22～7.09) were the risk factors of LBW. Conclusion Negative life events might affect LBW and negative life events occurring in the different term of pregnancy impact LBW differently.