摘要目的 探讨孕期职业紧张和不良生活事件对匀称型和不匀称型低体重儿的影响.方法 选择438例低体重儿(匀称型337例,不匀称型101例)为病例组,438名正常新生儿为对照组,用多因素logistic回归分析控制产妇年龄、职业、文化程度和家庭月人均收入等因素后,分析孕期职业紧张和不良生活事件与两类低体重儿的关系.结果 职业紧张对孕期的影响显示,同技术使用程度低者相比,技术使用程度高的孕妇显著降低分娩匀称型(OR=0.69,95%CI:0.49～0.98)和不匀称型(OR=0.53,95%CI:0.31～0.89)低体重儿的危险性.与孕期未发生生活事件的孕妇相比,在整个孕期生活事件指数≥3分显著增加匀称型低体重儿的风险(OR=2.30,95%CI:1.08～4.88),在孕中期生活事件指数≥3分(OR=8.85,95% CI:1.97～39.68)、孕晚期生活事件指数≥3分(OR=3.80,95%CI:1.40～10.29)以及整个孕期生活事件指数2分(OR=3.58;95 % CI:1.33～9.66)和≥3分(OR=3.48,95% CI:1.32～9.13)显著增加非匀称型低体重儿的危险性.结论 孕期发生职业紧张和不良生活事件对不同类型低体重儿的发生产生影响,不同孕期发生的不良生活事件对不同类型低体重儿的影响存在差异.

abstractsObjective To explore the influence of occupational stress and negative life events that occur during pregnancy on different types of low birth weight (LBW). Methods 438 singleton LBW infants (birth weight of less than 2500 g and their pregnancy term from 28 to 42 weeks) were selected as case group, and they were further divided into symmetric LBW infants (337 cases) and asymmetric LBW infants (101 cases). According to situation of each LBW infant, a singleton with full term and normal birth weight was selected as control group matched by sex, pregnancy term, time during delivery and types of hospital.All of their mothers were inquired by well trained investigators on their socio-demographic characteristics, occupational stress, and negative life events that occurred in different pregnancy term. After controlling for mother's age, occupation,education level and family income, multinomial logistic regression was employed to asses the influence of occupational stress and negative life events on symmetric LBW and asymmetric LBW. Results Compared with those using low technical skills, mothers with high technical skill utilization significantly decreased the risk of laboring both symmetric LBW ( OR = 0.69, 95 ％ CI:0.49-0.98) and asymmetric LBW (OR = 0.53,95％CI: 0.31-0.89). Compared with those without exposure to negative life events, mothers with negative life event score ≥ 3 in the whole duration of pregnancy had significantly increased the risk of delivering symmetric LBW ( OR = 2.30, 95％ CI : 1.08-4.88), mothers with negative life event score ≥3 in the middle three months of pregnancy, ≥3 in the last three months of pregnancy, = 2 and ≥3 in the whole duration of pregnancy had significantly increased the risk of delivering asymmetric LBW, and their OR (95 ％ CI ) was 8.85 (1.97-39.68), 3.80 ( 1.40-10.29 ),3.58(1.33-9.66) and 3.48 (1.32-9.13), respectively. Conclusion Occupational stress and negative life events might produce different influence on symmetric LBW and negative life events that occurr in the different terms of pregnancy had different impact on symmetric LBW and asymmetric LBW.