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目的了解我国城市足月新生儿张路指数(Zhang-Lu index,ZLI)的变化及其影响因素。方法采取随机整群抽样的方法收集了北京、哈尔滨、长沙及广州4个城市足月单胎活产新生儿体格发育数据,并与全国ZLI参考值进行对比分析,运用多元线性回归模型筛选ZLI影响因素。本次共调查足月新生儿5140例,其中北京1207例,哈尔滨1271例,长沙1250例,广州1412例。结果 1)2012年37~41周不同胎龄新生儿ZLI均大于利用1989-1990年收集的数据建立的全国ZLI参考值,差异有统计学意义(P<0.01),ZLI平均增长值为0.07。2)多元线性回归分析显示,影响ZLI主要因素为胎龄、母亲妊娠前体质指数及妊娠期增加体重,母亲产次、年龄、文化程度、职业及新生儿性别等对ZLI影响不大。结论我国四城市足月新生儿张路指数的变化呈现增加趋势。为提高出生人口质量,应从降低导致早产的原发性疾病的发生、做好孕前体质指数调控及科学制定孕期适宜增重标准等可控因素进行孕前及孕期健康指导。
Objective To understand the changes of Zhang-Lu index (ZLI) in urban full-term neonates and its influencing factors. Methods The physical development data of newborns with term singleton live birth in Beijing, Harbin, Changsha and Guangzhou were collected by random cluster sampling and compared with the national ZLI reference value. The multiple linear regression model was used to screen the influence of ZLI factor. The total of 5140 newborns were surveyed, of which 1207 were from Beijing, 1271 from Harbin, 1250 from Changsha and 1412 from Guangzhou. Results 1) The ZLI of newborns with different gestational age from 37 to 41 weeks in 2012 was greater than the national reference value of ZLI established by using the data collected from 1989 to 1990 (P <0.01), and the average growth of ZLI was 0.07. 2) Multiple linear regression analysis showed that the main factors affecting ZLI were gestational age, mother’s body mass index before pregnancy and gestational weight gain, mothers birth frequency, age, education level, occupational and neonatal gender had little effect on ZLI. Conclusion The changes of Zhangluo index of full-term newborns in four cities of China show an increasing trend. In order to improve the quality of the population at birth, we should guide the health before and during pregnancy by controlling factors such as reducing the incidence of primary diseases leading to premature delivery, controlling the body mass index before pregnancy and scientifically setting the appropriate standard of weight gain during pregnancy.