基于移动终端开展中国新生儿出生特征研究

doi:10.19723/j.issn.1671-167X.2019.05.004

摘要/Abstract

摘要：

目的:描述中国新生儿出生特征,并评价应用移动终端采集妇幼健康基础信息和开展相关流行病学研究的可行性。方法:2016年6月至2017年1月,在全国23个省份166家助产机构募集孕产妇,应用手机终端自填式问卷采集分娩方式、孕周和出生体质量等基础信息,描述剖宫产、早产、出生体质量、身长和头围等常用妇幼健康指标的发生率或平均水平。与2005年中国7岁以下儿童生长发育标准、2006年世界卫生组织儿童生长发育标准以及2014年中国不同胎龄新生儿出生体质量标准比较,评价数据的可信性。结果:调查产妇9 986名,其中35岁及以上者占11.7%,大专及以上学历者占70.2%。剖宫产、早产、低出生体重儿和巨大儿的发生率依次为38.1%、4.5%、2.2%和7.8%;新生儿平均出生体质量(3.33±0.44) kg [男(3.36±0.44) kg,女(3.29±0.43) kg],身长(50.97±2.32) cm [男(51.04±2.32) cm,女(50.89±2.32) cm],头围(33.99±1.56) cm [男(34.01±1.57) cm,女(33.97±1.55) cm]。与不同时期全国数据比较显示,剖宫产率和足月儿胎龄别出生体质量接近2014年全国水平,平均出生体质量和身长高于2005年中国生长发育标准、也高于2006年世界卫生组织生长发育标准。结论:男、女婴出生体质量较10年前的全国数据分别增加40 g和80 g,身长分别增加0.6 cm和1.3 cm,头围则与10年前相近,提示10年来我国新生儿体质状况明显改善,同时,信息化的发展可能为流行病学研究提供新途径。

关键词: 流行病学, 妇幼卫生, 新生儿, 移动终端, 数据收集

Abstract:

Objective: To describe the birth characteristics for Chinese newborns, to assess the feasibility of collecting basic data on maternal and child health, and to conduct relevant epidemiological studies by using mobile terminals. Methods: From June 2016 to January 2017, pregnant women who delivered in hospitals were recruited in 166 hospitals scattered across 23 provinces of China. The data on their maternal and child health including delivery mode, gestational age and birth weight, were collected by self-administered questionnaires embedded in a mobile application. The incidences or means of cesa-rean section, preterm birth, birth weight, length and head circumference were calculated and compared with recognized national data, including 2005 Growth Standards for Chinese Children Under 7 Years of Age, 2006 World Health Organization Child Growth Standards and 2014 Chinese Neonatal Birth Weight Standards by Gestational Age. Results: A total of 9 986 women were investigated, among whom those aged ≥35 years accounted for 11.7% and those received well education (college and above) accounted for 70.2%. The rate of cesarean section, preterm delivery, low birth weight and macrosomia were 38.1%, 4.5%, 2.2%, and 7.8%, respectively. The means were (3.33±0.44) kg [male (3.36±0.44) kg, female (3.29±0.43) kg] for birth weight, (50.97±2.32) cm [male (51.04±2.32) cm, female (50.89±2.32) cm] for birth length, and (33.99±1.56) cm [male (34.01±1.57) cm, female (33.97±1.55) cm] for head circumference, respectively. As compared with the national data, the cesarean section rate and birth weights by gestational age for term-born neonates were similar to the latest national data in 2014, while the means of birth weight and length were obviously higher than those of the 2005 Growth Standards for Chinese Children Under 7 Years of Age and 2006 World Health Organization Child Growth Standards. Conclusion: As compared with the national data 10 years ago, the mean birth weights for male and female newborns were increased by 40 g and 80 g respectively and mean lengths by 0.6 cm and 1.3 cm, but changes for mean head circumferences were negligible, indicating that the physical health condition for Chinese newborns improved significantly over past 10 years and emerging information technology likely provided a new approach for epidemiological research.

Key words: Epidemiology, Maternal and child health, Newborn, Mobile terminal, Data collection

中图分类号:

R174

赵丽君,李宏田,张亚黎,周玉博,刘建蒙. 基于移动终端开展中国新生儿出生特征研究[J]. 北京大学学报（医学版）, 2019, 51(5): 813-818.

Li-jun ZHAO,Hong-tian LI,Ya-li ZHANG,Yu-bo ZHOU,Jian-meng LIU. Mobile terminal-based survey on the birth characteristics for Chinese newborns[J]. Journal of Peking University(Health Sciences), 2019, 51(5): 813-818.

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Items	Number	Proportion/%
Maternal age/years^*
≤19	89	1.0
20-34	7 743	87.3
≥35	1 039	11.7
Education^*
College and above	5 790	70.2
High school	1 343	16.3
Middle school or below	1 117	13.5
Parity
First	6 046	60.5
Second	3 607	36.1
Third and above	333	3.3
Hospital level
Tertiary	6 247	62.6
Secondary	3 196	32.0
Primary	543	5.4
Economic regions
East	6 200	62.1
Middle	1 641	16.4
West	2 145	21.5
Neonatal gender
Male	5 646	56.5
Female	4 340	43.5

Items	East, n (%)	Middle, n (%)	West, n (%)
Maternal age/years^*
≤19	55 (1.1)	11 (0.7)	23 (1.1)
20-34	4 458 (86.7)	1 361 (84.6)	1 924 (90.7)
≥35	628 (12.2)	236 (14.7)	175 (8.3)
Education^*
College and above	3 153 (65.4)	1 089 (76.2)	1 548 (77.4)
High school	860 (17.8)	201 (14.1)	282 (14.1)
Middle school or below	807 (16.7)	139 (9.7)	171 (8.6)
Parity
First	3 602 (58.1)	943 (57.5)	1 501 (70.0)
Second	2 353 (38.0)	638 (38.9)	616 (28.7)
Third and above	245 (4.0)	60 (3.7)	28 (1.3)
Hospital level
Tertiary	3 845 (62.0)	1 227 (74.8)	1 175 (54.8)
Secondary	1 862 (30.0)	414 (25.2)	920 (42.9)
Primary	493 (8.0)	0 (0)	50 (2.3)

Items	Cesarean section, n (%)	Preterm birth, n (%)	Low birth weight, n (%)	Macrosomia, n (%)
Overall	3 802 (38.1)	452 (4.5)	218 (2.2)	780 (7.8)
Maternal age/years
≤19	23 (25.8)^#	8 (9.0)^#	3 (3.4)	5 (5.6)
20-34	2 707 (35.0)	326 (4.2)	158 (2.0)	597 (7.7)
≥35	564 (54.3)	70 (6.7)	28 (2.7)	90 (8.7)
Education
College and above	2 061 (35.6)^#	214 (3.7)^#	94 (1.6)^#	428 (7.4)
High school	548 (40.8)	81 (6.0)	40 (3.0)	117 (8.7)
Middle school or below	422 (37.8)	73 (6.5)	43 (3.9)	94 (8.4)
Parity
Primipara	1 960 (32.4)^#	252 (4.2)^*	125 (2.1)	469 (7.8)
Multipara	1 842 (46.8)	200 (5.1)	93 (2.4)	311 (7.9)
Economic regions
East	2 451 (39.5)^#	305 (4.9)^*	150 (2.4)	526 (8.5)^#
Middle	652 (39.7)	58 (3.5)	25 (1.5)	120 (7.3)
West	699 (32.6)	89 (4.2)	43 (2.0)	134 (6.3)
Hospital level
Tertiary	2 493 (39.9)^#	281 (4.5)	132 (2.1)	493 (7.9)
Secondary and below	1 309 (35.0)	171 (4.6)	86 (2.3)	287 (7.7)
Neonatalgender
Male	2 088 (37.0)^*	264 (4.7)	107 (1.9)^*	511 (9.1)^#
Female	1 714 (39.5)	188 (4.3)	111 (2.6)	269 (6.2)

Items	Male			Female
Items	Birth weight/kg	Length/cm	Head circumference/cm	Birth weight/kg	Length/cm	Head circumference/cm
This survey	3.36±0.44	51.0±2.3	34.0±1.6	3.29±0.43	51.0±2.3	34.0±1.6
2005 Chinese Standards	3.32±0.39^*	50.4±1.8^*	34.5±1.2^*	3.21±0.39^*	49.7±1.7^*	34.0±1.2
2006 WHO Standards	3.35±0.49^*	49.9±1.9^*	34.5±1.3^*	3.23±0.46^*	49.1±1.9^*	33.9±1.2^*