The Changing Trends Of Birth Outcomes In Taicang,Jiangsu From 2009 To 2015 And Their Risk Factor Analysis

Objective:To investigate the changing trend of perinatal outcomes in Taicang,Jiangsu Province from 2009 to 2015,and to investigate the key problems in perinatal outcomes and their risk factors;to explore the influence of the joint effect of early pregnancy BMI and gestational weight gain to birth outcome.Methods:Electronic clinical records from 1st Jan 2009 to 31st Dec 2015 in all 28 clinical hospitals in Taicang,Jiangsu Province of China was retrived and Cochran-Armitage trend test was used to examine the changing trend of perinatal outcomes.Multiple logistic test was used to identify the risk factors of key problems.Results:The average neonatal sex ratio during the 7 years is 111.60:100 and remained stable(Z=0.74,P = 0.46);cesarean section rate decreased from 66.70%to 39.14%(Z = 25.73,P<0.001);preterm birth rate increased from 3.05%to 5.00%(Z=-5.50,P<0.001);LGA rate increased from 14.93%in 2009 to 18.25%in 2012,and decreased to 16.22%,with the average of 16.67%;SGA rate decreased from 7.21%to 2.51%(Z= 8.11,P<0.001);macrosomia rate fluctuated between 9.12%to 7.22%and did not show an increasing or decreasing trend;the average LBW rate is 2.60%during the 7 years and did not show an increasing or decreasing trend.Maternal low education,living in urban areas,high early pregnancy BMI,excessive GWG and gestational hypertension were risk factors for cesarean section.Low early pregnancy BMI and inadequate GWG were protective factors for cesarean section.Primipara,living in rural areas,high early pregnancy BMI and inadequate GWG were risk factors for preterm birth;excessive GWG was a protective factor for preterm birth.Older maternal age,multipara,high early pregnancy BMI and excessive GWG were risk factors for LGA;low early pregnancy BMI and inadequate GWG were pretective factors for LGA.Primipara,low early pregnancy BMI,inadequate GWG and gestational hypertension were risk factors for SGA.Multipara,low maternal education,living in urban areas,high early pregnancy BMI and excessive GWG were risk factors for macrosomia.Primipara,low early pregnancy BMI,inadequate GWG and gestational hypertension were risk factors for low birth weight.Conclusion:Anemia rate and birth sex ratio were high among rural areas and nonlocal population.Cesarean section rate and SGA rate decreased and preterm birth rate increased during the 7 years.Proper early pregnancy BMI and proper gestational weight have always been the important contents in perinatal care.Pregnant anemia,blood sugar abnormality and blood pressure abnormality should be paid close attention and be intervened as early.