母親危險因子對低出生體重嬰兒、早產兒、及生長遲滯嬰兒之影響－前瞻性懷孕世代研究

Objectives: This prospective cohort study investigated low birthweight (LBW), preterm delivery (PTD), and small for gestational age (SGA) in Taipei, Taiwan. Effects of maternal risk factors on birth outcomes were examined, including biological background, maternal obstetric history, as well as medical events and smoking during pregnancy. Methods: Between 1984 and 1987, each pregnant woman who came to the Taipei Municipal Maternal and Child Hospital for prenatal care was interviewed using a structured questionnaire. Maternal and newborn medical records were abstracted after delivery. A total of 12,273 singleton livebirths were analyzed. Potential risk factors associated with birth outcomes were examined using logistic models. Results: Antepartum hemorrhage and hypertension were the strongest risk factors for LBW or PTD history, and infection with syphilis had moderately increased risks. Female gender and primiparae were were also significantly associated with the risk of LBW infants. Antepartum hemorrhage was the strongest risk factor for PTD infants, whereas obese mothers, short fathers, two or more prior spontaneous abortions, and previous LBW or PTD history gave moderately increased risks. Maternal hypertension, low pre-pregnancy weight, and primiparae were the risk factors for both symmetric and asymmetric SGA infants Those effects except primiparae were considerably greater on asymmetric than symmetric SGA infants. Low parental height and previous LBW or PTD history were also significantly associated with the risk of symmetric SGA infants. Conclusions: The relationship between several known risk factors and birth outcomes consistently remains, and interventions should be promoted in Taiwan.