2012—2021年上海市非沪籍产妇分娩新生儿小于胎龄儿发生率的年龄-时期-队列效应分析

doi:10.12183/j.scjpm.2026.1017

摘要/Abstract

摘要： 目的分析2012—2021年上海市小于胎龄儿（small for gestational age,SGA）发生率的非沪籍产妇相关年龄、产婴时期和产妇出生队列效应及其特点。方法收集2012—2021年覆盖上海市所有接产机构报告的单胎新生儿出生登记信息,应用Stata 12.0的apc_ie模块估计产妇年龄、产婴时期和出生队列对SGA发生率的影响。结果 2012—2021年上海市全胎龄产妇、足月产妇的SGA发生率总体均呈下降趋势（z=-2.449、-2.451,均P<0.05）。年龄-时期-队列模型结果显示,全胎龄产妇SGA与足月产妇SGA的年龄、时期和队列效应相近。20~25岁时2类产妇SGA风险年龄效应显著较高（均RR>1,均P<0.05）,但随产妇年龄增加SGA发生率年龄别RR分别从1.77和1.83下降至1.10;26~42岁产妇2类SGA风险年龄效应较低（RR<1）,其中31~40岁、42岁效应显著（P<0.01或P<0.05）。2类SGA发生率时期别RR在2012—2021年总体均呈下降趋势,其中2012—2014年的时期别RR值均大于1（均P<0.01）,2015—2021年相应RR值均小于1（均P<0.01）。1970年2类产妇队列的SGA发生风险均最高,RR值分别为1.31、1.36（均P<0.05）;1976年、1978—1985年队列的RR值均小于1（P<0.01或P<0.05）;1989—1996年队列的RR值均大于1（P<0.01或P<0.05）。≥35岁非沪籍初产妇（简称高龄初产妇）比例在2016年起上升趋势较明显（趋势检验z=2.200,P<0.05）。结论上海市非沪籍产妇单胎新生儿SGA发生率呈显著下降趋势。上海市非沪籍产妇单胎新生儿SGA发生率具有特征性的产妇年龄效应、产婴时期效应以及产妇出生队列效应。上海非沪籍产妇高龄初产比例上升对新生儿SGA发生率的可能影响值得关注。

关键词: 小于胎龄儿, 年龄效应, 时期效应, 队列效应, 年龄-时期-队列模型

Abstract: Objective To analyze the age, period, and birth cohort effects of maternal factors on the incidence of small for gestational age (SGA) infants among non-Shanghai-registered parturients in Shanghai from 2012 to 2021. Methods Singleton birth registration data, encompassing all delivery institutions in Shanghai from 2012 to 2021, were collected. The apc_ie module in Stata 12.0 was employed to estimate the effects of maternal age, delivery period, and birth cohort on the incidence of SGA. Results A general downward trend was observed in the overall SGA incidence for both all-gestational-age and full-term singleton births among non-Shanghai-registered parturients from 2012 to 2021 (z=-2.449 and -2.451, respectively; both P<0.05). The Age-Period-Cohort model revealed comparable age, period, and cohort effects on SGA incidence between the all-gestational-age and full-term parturient groups. A significantly higher age effect on SGA risk was evident for parturients aged 20-25 years (RR>1, P<0.05 in both groups), with the age-specific relative risk (RR) declining from 1.77 and 1.83 to 1.10 as maternal age increased. Conversely, for parturients aged 26-42 years, the age effect on SGA risk was lower (RR<1), with significant effects observed at ages 31-40 and 42 (P<0.01 or P<0.05). The period-specific RR for SGA incidence demonstrated an overall decreasing trend throughout 2012-2021. The period RRs were consistently above 1 from 2012 to 2014 (all P<0.01) and below 1 from 2015 to 2021 (all P<0.01). Maternities from the 1970 birth cohort exhibited the highest risk of SGA, with RRs of 1.31 and 1.36 for the two groups, respectively (both P<0.05). In contrast, cohorts from 1976 and 1978-1985 showed RRs below 1 (P<0.01 or P<0.05), whereas cohorts from 1989-1996 displayed RRs greater than 1 (P<0.01 or P<0.05). Furthermore, a notable upward trend in the proportion of primiparas of advanced maternal age (≥35 years) was identified beginning in 2016 (trend test z=2.200, P<0.05). Conclusion The incidence of SGA among singleton neonates born to non-Shanghai-registered parturients has shown a significant decreasing trend. This incidence is characterized by distinct maternal age, delivery period, and maternal birth cohort effects. The rising proportion of primiparity at an advanced maternal age warrants attention for its potential impact on future SGA incidence.

Key words: Small for gestational age, Age effect, Period effect, Cohort effect, Age-period- cohort model

中图分类号:

R173

周峰, 虞慧婷, 范和玉, 王春芳. 2012—2021年上海市非沪籍产妇分娩新生儿小于胎龄儿发生率的年龄-时期-队列效应分析[J]. 华南预防医学, 2026, 52(9): 1017-1021.

Zhou Feng, Yu Huiting, Fan Heyu, Wang Chunfang. Age-period-cohort effects on the incidence of small for gestational age among infants of non-local mothers in Shanghai, 2012-2021[J]. South China Journal of Preventive Medicine, 2026, 52(9): 1017-1021.

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